The Unit for Clinical Caring Research Focusing on Immune Diseases and Immunotherapies and on Quality and Safety in Health-care

Dr Gardulf was the one to develop the rapid subcutaneous IgG replacement therapy, which today is commonly used worldwide. The 1st article about the method was published in The Lancet in 1991. She is one of the founders of both the National (SISSI, Sveriges Immunbristsjuksköterskors Intresseförening) and the International (INGID, International Nursing Group for Immunodeficiencies) Nurse PID Organisations.

The Nurse Professional Competence (NPC) Scale
Dr Gardulf is also active as a researcher within different research areas focusing on quality and safety in the Health-care. As an ongoing example, a national research group consisting of researcher from seven Universities/University Colleges has developed a new instrument to measures self-reported competence among registered nurses in clinical care - “The Nurse Professional Competence (NPC) Scale” (2013). The research group is now setting up a model to facilitate the implementation of the NPC Scale within the Swedish health-care system to make it possible to measure nurses’ competence over time, i.e. from newly graduated registered nurses to highly specialized nurses.

Primary immunodeficiencies (PID)
Primary immunodeficiencies (PID) ( > 200 types summarised) are recognized having about the same prevalence as diabetes. It has been estimated that about 40-50,000 individuals in Sweden are suffering from some form of PID. Although Sweden must be considered to hold a position in the frontline regarding research and clinical care of patients with PID, only 2,000 individuals have so far been diagnosed. Thus, many patients are still suffering from increased frequency and severity of infections due to lack of awareness of PID among Swedish health care staff. The most common PID is some form of primary antibody deficiency leading to an increased susceptibility to bacterial infections in the lungs, sinus and ears. Once diagnosed, it is possible to help the patients to a much healthier life and a better quality of life if the patients are given IgG on a regular basis (normally weekly). IgG (gammaglobulin) is a concentrate of ready-to-use-antibodies from healthy blood donors. In Sweden about 80% of both the children and the adult PID patients self-infuse at home. They then use a small portable pump to infuse the IgG subcutaneously. The remaining 20% of the patients receive their IgG replacement as intravenous IgG infusions at out-patient clinics at specialist clinics at the hospitals.

Well-trained and competent nurses are a prerequisite for a high-quality and safe care. Already in 2005, the National Board of Health and Welfare in Sweden set up formal competence requirements for registered nurses. Although these formal requirements have been in force for 8 years it has not been possible to evaluate nurses’ competence in relations to the national formal requirements until the NPC Scale was developed.