Bli en antibiotikasmart äldre- och funktionshinderomsorg (Become an antibiotic-smart elderly and disability care provider)

Objectives and Target Audience

Objective(s)

1. Systematic quality improvement: Support organizations to implement structured work on infection prevention (hygiene) and antibiotic stewardship within elderly and disability care settings
2. Reduce infections & antibiotic use: Focus on reducing healthcare-associated infections (HAIs), limiting infection spread, and thereby reducing the need for antibiotic treatments (e.g., UTIs) .
3. Foster engagement and inspiration: Motivate organizations to adopt the criteria, stimulate systematic improvement, and inspire consistent hygiene and antibiotic-smart work
4. Ensure realistic and measurable standards: Use criteria that are realistic, forward-moving, challenging, and evaluable—tailored for varied care providers, including municipal and subcontracted entities .
5. Support compliance with national guidance: Align with existing national infection prevention regulations (e.g., Socialstyrelsen’s HSLF-FS 2022:44) and WHO-based hygiene guidance

Target audience

Elderly people

Disable care providers

Campaign Scope

National

Collaborations

Partners or Allies

Vinnova

RISE – Research Institutes of Sweden

Municipalities and Regions

Communication Strategy

Communication Channels Used

websites/blogs

criteria documents

resources

Webinars

meetings

Campaign Material(s)

Tools & checklists

Guidance documents

External hygiene guidance

Word/PowerPoint/email templates

Key messages

-To protect the elderly, it is of great importance that there is effective infection prevention work within all activities, which also includes work to reduce the need for antibiotic treatment.

Campaign Focus

Human health

Campaign Setting

Elderly and disability care homes

Design and Content

Use of Scientific Evidence

Implicit Evidence-Based Messaging

Pedagogical Approach

Educational model applied

Transmissive

Participatory

Constructivist

Content Complexity Level

Intermediate

Diversity and Inclusion

Content accessibility

Cultural Sensitivity and Contextualization

Yes

Dissemination and Sustainability

Continuity strategy

Campaign with regular updates

Replicability

Yes

Content usage license

Free

Campaign Status

Active

Funding

Estimated budget

2 200 000 €

Lessons and Observations

Identified gaps

Credibility assumed due to source, no references

Accessible formats for hearing impaired users not provided

Key messages not clearly indicated

Interactive features not included

Reporting on results or impact not found

Outreach activities not documented

Lack of infection tracking

Lack of team based reviews

Lack of end user engagement

Limited visual transparency

Lack of external validation

1.Infection tracking: Existing routines may track general infection rates but lack detail by infection type, severity, or treatment outcome.
2. Team-based reviews: Implementation of hygiene audits and improvement work is often done by single-role actors, limiting perspectives.
3. End user engagement: Limited involvement of residents, clients, or family members in hygiene or infection prevention strategies. No establish feedback mechanisms (surveys, interviews) nor participatory workshops with residents/families to raise awareness and gather input.
4. Visual transparency: Lack of live or periodic visual dashboards (e.g., infection rates per unit) displayed in staff areas to promote transparency.
5. Sustainability: Diploma or award cycles may end without a plan to maintain hygiene initiatives long-term.
6. External validation: Internal self-assessments may miss blind spots.

Lessons learned

Tailoring content to specific groups (e.g., parents, seniors, teens) may enhance impact.

"Listen" button available improves accessibility for different audience

Cross-sector collaboration (e.g., health, education, environment) may support integrated approaches like One Health.

A central campaign hub or website can improve discoverability and consistency.

Personal stories build empathy

Extracted from The Public Health Agency of Sweden’s Annual Report 2024 available at Documents and online at https://www.folkhalsomyndigheten.se/contentassets/55b7f293f4ce4d84bef6de661d49d6c3/folkhalsomyndighetens-arsredovisning-2024.pdf?utm_source=chatgpt.com
1. Piloting builds relevance: Pilot testing with nearly 100 organizations (including municipalities and care units) before full rollout ensured that criteria and materials were practical, understandable, and aligned with real-world care settings
2. Co-creation increases uptake: The development process actively involved hygiene representatives and care personnel, ensuring that the final criteria and resources were relevant, culturally appropriate, and immediately applicable .
3. Structured criteria drive action: A clear, criterion-based framework reinforced local accountability, making it easier to track progress, self-assess, and work systematically toward achieving standards .
4. Diplomas motivate, but bustainability needs support: The one-year diploma model adds recognition and motivation; however, outcomes depend on ongoing follow-up and support beyond initial certification .
5. Integrated data systems enhance monitoring: Embedding antibiotic and infection surveillance (e.g., using Svebar, HALT, MedRave) into routine activities created data-driven feedback loops, supporting sustainable hygiene improvements
6. Networks and collaboration are critical: Success relied on existing professional and regional networks (e.g., STRAMA, regional infection control units) which provided credibility, local insight, and peer support .
7. Flexibility supports diverse care settings: Tools like annual cycle calendars and adaptable templates allowed facilities of various sizes and organizational models (municipal, subcontracted) to tailor their approach .

Identified biases

Digital Access Bias

Digital Literacy Bias

Disability Accessibility Bias

Evaluation Absence Bias

1. Selection bias: Facilities that choose to participate (e.g., pilot testers) are often better resourced or more motivated, potentially skewing results.
2. Engagement bias: Limited formal mechanisms for including the perspectives of residents or families in infection control decision-making.

Identified Weaknesses

Unclear or confusing messaging

No Measurable Outcomes or Evaluation Plan

1. Sustainability of diplomas: The one-year diploma is motivational, but ongoing renewal and long-term engagement require continued effort and support
2. Potential variability in follow-up quality
The effectiveness of measurement and feedback depends on how well individual units plan and execute follow-up and reporting—some may struggle without additional guidance .
3. Resource constraints in smaller units: Smaller facilities may lack sufficient staff or time for training, surveillance, and leadership delegation—impacting implementation fidelity.
4. Limited patient & public participation: While staff and organizational stakeholders are engaged, there is less emphasis on including patients or families directly—missing a broader community perspective.
5. Data system integration gaps: Regional differences in access to surveillance systems (like HALT, MedRave) could lead to uneven monitoring capacity across municipalities

Identified Strengths

Community participation

Engagement with stakeholders

Easy to locate materials

Endorsements by Trusted Institutions

1. Pilot testing & co-creation: Nearly 100 care units piloted the criteria, and staff were actively involved in co-developing them—ensuring relevance, practicality, and local ownership
2. Structured, criteria-based framework: Clear, realistic, and evaluable criteria help drive systematic hygiene improvement and accountability
3. Embedded infection surveillance tools: Utilization of HALT and other infectious-disease monitoring tools integrates data-driven feedback into routine operations (Learn more about HALT is a tool for collecting data on healthcare-associated infections, the occurrence of risk factors in care recipients, and antibiotic use. at https://www.folkhalsomyndigheten.se/smittskydd-beredskap/vardhygien-och-vardrelaterade-infektioner/svenska-halt/)
4. Local leadership & hygiene champions: Designation of internal hygiene leads fosters peer-driven implementation and consistent follow-up .
5. Alignment with national standards: The framework aligns with national guidelines (Socialstyrelsen and WHO), promoting legitimacy and regulatory coherence
6. Focused staff training: Annual training in basic hygiene and infection control ensures staff competence and readiness

Documents