Infection control link nurses have been appointed in most Dutch nursing home organizations, but a new study shows that what these nurses actually do in practice varies considerably from one location to another. The research, published in Antimicrobial Resistance & Infection Control, examined how the infection control link nurse role is implemented in nursing homes, how the nurses enact it on the ward floor, and which factors shape that enactment. The findings suggest that organizational conditions, particularly supervisor engagement and access to expert input, may determine whether link nurses take a proactive or a reactive approach to infection prevention and control.
Yet, as the researchers note, little was known about how this role is actually enacted in day-to-day practice, which is why they designed a study to examine implementation, enactment and the influencing factors together.
The study used a multimethod design. The researchers administered two questionnaires and conducted semi-structured interviews with infection control link nurses working in nursing homes. The first questionnaire addressed implementation at the organizational level, while the second focused on local enactment at the location level. Respondents were recruited through snowball sampling, starting from initial contacts identified through broad outreach and professional networks. Quantitative data were analyzed descriptively, and the qualitative interview material was analyzed using a thematic analysis-informed approach.
Between June 2024 and January 2025, 118 questionnaires were completed and 21 semi-structured interviews were conducted with infection control link nurses. The organizational questionnaire showed that within most nursing home organizations, link nurses had been appointed: 30 of 36 organizations, or 83.3 percent, reported having ICLNs in place. However, the organizational infection prevention and control structure within which the role was embedded varied considerably between organizations, and so did the extent of training and support provided to the nurses holding the role.
The second questionnaire, administered at the location level, revealed variation in how the link nurses enacted their role in practice. The interviews helped clarify what lay behind these differences. According to the researchers, organizational alignment and the degree to which supervisors prioritized infection prevention and control shaped the availability of resources, specifically training and allocated time for the role.
Supervisor engagement appeared to have a second, more subtle effect: it influenced how much authority the link nurses perceived themselves to have and how they viewed their own role. In turn, the study found that facilitation of the practical application of infection prevention, through expert input or peer learning, supported more proactive role enactment and ongoing improvements in infection prevention and control practice.
These nurses more often described a reactive approach to infection prevention and control, and they also reported feeling less capable of achieving sustained improvements in IPC.
The authors draw a cautious conclusion from these patterns. The ICLN role, they write, has been widely implemented in nursing homes, but its enactment varies and is influenced by multiple factors. Their findings suggest that supportive organizational conditions may be important for enabling proactive role enactment, possibly by strengthening the link nurses’ sense of role ownership. Additionally, the presence of a dedicated facilitator may enable link nurses to identify opportunities for infection prevention improvement and to follow up on those opportunities.
The questionnaires were analyzed descriptively, so the study reports patterns and associations rather than causal effects. Recruitment relied on snowball sampling through professional networks, which means the respondents may not represent all nursing home organizations and all link nurses in the sector.
Even with those caveats, the study offers a concrete picture of a strategy that many nursing home organizations have already adopted.
Subject of Research: Implementation and enactment of infection control link nurse roles in nursing homes
Article Title: Enactment of infection control link nurse roles in nursing homes; a multimethod study
Article References: van der Horst, I. R., van Buul, L. W., Jongerden, I., van Mansfeld, R., Dekker, M., & Kuil, S. D. (2026). Enactment of infection control link nurse roles in nursing homes; a multimethod study. Antimicrobial Resistance & Infection Control. https://doi.org/10.1186/s13756-026-01855-z
Image Credits: AI Generated
DOI: 10.1186/s13756-026-01855-z
Keywords: infection prevention and control, nursing homes, link nurses, role enactment, implementation science, multimethod study, questionnaires, semi-structured interviews, organizational support, long-term care, Enactment, infection
News Source: Kristina Jarvis. (November 6, 2026). Infection control link nurses are common in nursing homes, but their roles vary widely. Scienmag.
