Healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: barriers and facilitators

Added April 21, 2020

Citation: Houghton C, Meskell P, Delaney H, et al. Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2020; (4): CD013582

What is this? Physical interventions to prevent and control infections should interrupt or reduce the spread of COVID-19. Information on the barriers and facilitators to healthcare worker’s adherence to the relevant guidelines should help in planning and implementing these strategies.

In this rapid Cochrane qualitative evidence synthesis, the authors searched for qualitative research on the experiences and perceptions of healthcare workers relevant to their adherence to infection prevention and control (IPC) guidelines for respiratory infectious diseases. They did not restrict by date or language of publication and did their search on 28 March 2020. They identified 36 relevant studies and sampled 20 for their analysis. These studies were from Asia (10 studies), Africa (4), Central and North America (4) and Australia (2). A summary of the implementation considerations identified is available here.

What was found: Healthcare workers found it confusing when IPC guidelines were too long and ambiguous or if they differed from national and international guidance.

Healthcare workers’ responses to IPC guidelines were influenced by the level of support from their management team.

A lack of personal protective equipment (PPE), or PPE that was of poor quality, was a serious concern for healthcare workers.

Healthcare workers pointed to a need for training about the respiratory infection itself and about how to use PPE, and that this was important for all staff in a healthcare setting.

Healthcare workers highlighted the need for sufficient space to isolate patients, including the need for isolation and waiting rooms, and shower facilities for staff.

If a healthcare worker believed in the value and effectiveness of IPC guidelines, this helped adherence.

Healthcare workers felt motivated to follow the guidance because of fear of infecting themselves and their families, or because they felt responsible for their patients.


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