ISR 61 - Determinants in Implementing Infection Prevention and Control Practice in Nursing Homes: A Scoping Review Based on Theoretical Domains Framework

Background: The current novel coronavirus pandemic has highlighted the importance of infection prevention and control (IPC) in nursing homes (NH). Implementing effective IPC requires behavioral changes in NH healthcare workers. When considering promising IPC interventions, a comprehensive understanding of the determinants of behavioral change is needed. We aimed to identify the determinants of IPC behavioral changes in NH healthcare workers from a comprehensive literature review and map these determinants based on the theoretical domains framework (TDF). Additionally, we aimed to identify the research gap in this research field.

Methods: We used a scoping review methodology based on the Joanna Briggs Institute Manual for Evidence Synthesis. We conducted an online literature search up to March 31, 2022, using two medical and nursing field databases, searching for literature 1) concerning IPC practice in NH and 2) exploring the determinants of IPC practice implementation among healthcare workers in NH. Next, we extracted descriptions of IPC practice determinants from the eligible literature and performed a TDF-based thematic analysis consisting of 14 domains.

Results: From 1,161 identified records, we included 25 reports. Seventy-six determinants of IPC practice were identified based on the thematic analysis. The "Environment Context and Resources" domain was the most frequently extracted domain, containing 25 determinants, of which the most frequently extracted determinants were "inadequate facility infrastructure," "insufficient sanitation equipment," "low staffing," and "conflict between home-like care and IPC practice." The next most frequently extracted domain was "Social Influences," containing 10 determinants. We were able to extract the least number of determinants in the "Social/Professional Role and Identity," "Belief about Capability," "Optimism," "Reinforcement," "Goals," and "Emotions" domains.

Conclusions: In this review, we identified and mapped 76 determinants of IPC behavior changes in NH healthcare workers based on TDF. Research gap exists in domains related to individuals' beliefs, perceptions, and motivations about IPC practice.