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Infection prevention and control in nursing homes under pandemic-level pressure: qualitative insights from Swedish care workers
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0009-0008-4228-0692
Department of Infectious Diseases, Skåne University Hospital, Region Skåne, Lund, Sweden; Department of Clinical Sciences, Division of Infection Medicine, Lund University, Lund, Sweden.
Department of Communicable Disease Prevention and Control, Region Jämtland Härjedalen, Östersund, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0000-0003-0548-5943
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2026 (English)In: Antimicrobial Resistance and Infection Control, E-ISSN 2047-2994, Vol. 15, no 1, article id 55Article in journal (Refereed) Published
Abstract [en]

Background: The COVID-19 pandemic placed considerable pressure on nursing homes, where care workers faced high workloads, uncertainty, and emotional strain while also being expected to implement extensive infection prevention and control (IPC) measures. Understanding how such everyday experiences affect adherence to IPC measures is essential for strengthening future guideline implementation and training. This study aimed to explore care workers’ experiences during the COVID-19 pandemic, with a focus on IPC measures and the realities of everyday work.

Methods: A qualitative descriptive design was used. Semi-structured interviews were conducted with 22 nurse assistants and care aides from 19 nursing homes in northern and southern Sweden (May–November 2023). The interviews were recorded, transcribed and then analyzed using inductive qualitative content analysis. The study was guided by the Consolidated Criteria for Reporting Qualitative Research.

Results: Three main categories captured nurse assistants’ and care aides’ experiences of how demanding everyday realities during the pandemic shaped adherence to IPC measures. (1) Organizational determinants highlighted the importance of leadership presence, clear information, and resource availability. (2) Individual aspects described how knowledge, beliefs, and physical discomfort influenced motivation to adhere. (3) Ethical issues related to IPC measures reflected tensions between IPC practices and meeting residents’ social and emotional needs.

Conclusions: This study highlights how leadership, resources, and knowledge supported IPC adherence, while personal beliefs and ethical implications complicated practice. Future preparedness requires policies that integrate organizational support with the human dimensions of care, ensuring that infection control and dignified care are mutually reinforced.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2026. Vol. 15, no 1, article id 55
Keywords [en]
Adherence, Care workers, COVID-19, Infection prevention and control, Nursing homes, Qualitative
National Category
Nursing
Identifiers
URN: urn:nbn:se:umu:diva-252609DOI: 10.1186/s13756-026-01744-5ISI: 001739906700001PubMedID: 41981686Scopus ID: 2-s2.0-105035822073OAI: oai:DiVA.org:umu-252609DiVA, id: diva2:2056299
Funder
Swedish Research Council, 2021–04665Swedish Research Council, 2024–03244Visare Norr, VISARENORR-968921Region Västerbotten, RV-970105Region Västerbotten, RV-982630Region Västerbotten, RV-996381Available from: 2026-04-28 Created: 2026-04-28 Last updated: 2026-04-28Bibliographically approved

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Pettersson, JohannaJohansson, AndersBackman, Annica C.

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