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Peer reviewedCOVID-19SARSInfluenza

Factors that impact on healthcare workers' adherence with infection prevention and control (IPC) guidelines for COVID-19: a qualitative evidence synthesis.

The Cochrane database of systematic reviews·

Houghton C, Meskell P, Delaney H, Sheehan S, O Donoghue C, Glenton C, Booth A, Jorem G, Chan XHS, Devane D, Biesty LM

DOI
10.1002/14651858.cd016384
PMID
42677895
PMCID
OpenAlex
Study type
Systematic review
Publisher
Publisher unavailable
Article type
journal-article
Integrity
current

Why this research matters now

The review offers implications for practice, including communication strategies, training, and supply provision, intended to support policymakers and decision-makers managing IPC during ongoing and future pandemic responses.

01

Structured evidence summary

Research question

The review asks how healthcare workers' adherence to Infection Prevention and Control (IPC) guidelines for COVID-19 is influenced by contextual factors, and how the COVID-19 experience compares with other respiratory infectious diseases.

Study design

An updated qualitative evidence synthesis using purposive sampling of data-rich studies, framework analysis, CASP-based appraisal, and GRADE-CERQual confidence assessments. It updates a 2020 rapid review.

Population and setting

Healthcare workers across hospitals, long-term care, and community settings worldwide. The 26 analysed studies drew on nurses, doctors, allied and support workers, spanning high-, middle-, and low-income countries across Asia, Africa, North and South America, Oceania, and Europe.

Main findings

Twenty-seven findings were identified describing barriers and facilitators of healthcare workers' adherence to IPC guidelines. Adherence was supported by clear communication, managerial support, training opportunities, sufficient and equitable PPE access, and adequate physical infrastructure. Adherence was hindered by busyness, understaffing, patient or visitor non-compliance with masking and distancing, and poor-quality or ill-fitting PPE. Worry about infecting others decreased after vaccination rollout.

Public-health relevance

The review offers implications for practice, including communication strategies, training, and supply provision, intended to support policymakers and decision-makers managing IPC during ongoing and future pandemic responses.

Important limitations

Included studies were largely from the earlier phase of the pandemic, and the search was not updated after April 2024. Confidence in findings was mixed, including three low-confidence results out of 27. The summary is limited to the supplied single-article abstract and metadata and requires the original paper for decision-grade interpretation.

GIDS interpretation

The synthesis catalogues reported organisational, behavioural, and resource factors that shape the discoverability and uptake of IPC guidance in clinical settings. It does not by itself confirm any live surveillance signal; linking it to such signals would require separate, external evidence.

02

Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

03

Evidence relationships

This article has 12 auditable classifier relationships to diseases, places, topics, and study design.

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