Infection control and hospital epidemiology · 2026
Facilitators and barriers for implementing infection prevention interventions in long-term care: a scoping review.
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Miagostovich Ambra, Willemsen Ina, Habben Jansen Thera, de Vet Emely
Аннотация
INTRODUCTION: Infection prevention and control (IPC) is essential to reduce healthcare-associated infections in long-term care facilities (LTCFs). Its implementation faces unique challenges and is less studied than in acute care. This scoping review mapped barriers and facilitators to IPC implementation in LTCFs.
METHODS: Standardized procedures for scoping reviews were followed (eg, PRISMA-ScR). PubMed, Web of Science, CINAHL and PsycINFO were searched (2008-2025). Out of 965 articles, 21 studies were included. Data were charted and mapped to the (sub)domains of the Consolidated Framework for Implementation Research (CFIR).
RESULTS: Studies covered nursing homes, pediatric care, and disability care facilities in North America (n = 11), Europe (n = 8), Australia (n = 2) and Asia (n = 1). Most focused on hand hygiene and healthcare staff. Barriers and facilitators were identified across five CFIR domains. Intervention characteristics: Complex, untailored guidelines hindered use, while concise, context-specific protocols and adequate supplies enhanced adherence. Individual characteristics: Knowledge gaps, low risk perception, and competing priorities reduced adherence, whereas motivation, outbreak experience, and professional responsibility supported compliance. Inner setting: Staff shortages, high workload, and limited leadership were major barriers, while managerial engagement, supportive culture, and IPC champions promoted success of IPC. Outer setting: Limited policy support constrained implementation, whereas collaboration with public health agencies and peer networks facilitated it. Implementation process: limitations were lack of structured approaches; but ongoing training, peer feedback, and evaluation were key facilitators.
CONCLUSION: Many barriers and facilitators towards IPC in LTCFs were identified that can inform future implementation strategies. Implementation processes were rarely considered and need attention in research and practice.
METHODS: Standardized procedures for scoping reviews were followed (eg, PRISMA-ScR). PubMed, Web of Science, CINAHL and PsycINFO were searched (2008-2025). Out of 965 articles, 21 studies were included. Data were charted and mapped to the (sub)domains of the Consolidated Framework for Implementation Research (CFIR).
RESULTS: Studies covered nursing homes, pediatric care, and disability care facilities in North America (n = 11), Europe (n = 8), Australia (n = 2) and Asia (n = 1). Most focused on hand hygiene and healthcare staff. Barriers and facilitators were identified across five CFIR domains. Intervention characteristics: Complex, untailored guidelines hindered use, while concise, context-specific protocols and adequate supplies enhanced adherence. Individual characteristics: Knowledge gaps, low risk perception, and competing priorities reduced adherence, whereas motivation, outbreak experience, and professional responsibility supported compliance. Inner setting: Staff shortages, high workload, and limited leadership were major barriers, while managerial engagement, supportive culture, and IPC champions promoted success of IPC. Outer setting: Limited policy support constrained implementation, whereas collaboration with public health agencies and peer networks facilitated it. Implementation process: limitations were lack of structured approaches; but ongoing training, peer feedback, and evaluation were key facilitators.
CONCLUSION: Many barriers and facilitators towards IPC in LTCFs were identified that can inform future implementation strategies. Implementation processes were rarely considered and need attention in research and practice.