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Implementation of infection prevention and control for hospitalized neonates: A narrative review
Emanuela Nyantakyi1, Laura Caci1, Marta Castro2
1Institute for Implementation Science in Health Care, Medical Faculty, University of Zurich, Zurich, Switzerland.
Insights
Healthcare-associated infections in neonatal care are preventable. This review identifies factors influencing infection prevention and control (IPC) programs, highlighting organizational aspects like staffing and leadership to improve implementation.
Area of Science:
- Neonatal care
- Infection Prevention and Control (IPC)
- Implementation Science
Background:
- Healthcare-associated infections (HAIs) are common in neonatal units.
- Most HAIs are preventable through evidence-based IPC practices.
- Gaps persist in IPC implementation and understanding of influencing factors in neonatal care.
Purpose of the Study:
- To identify determinants influencing the implementation of IPC programs and best practices in inpatient neonatal settings.
- To synthesize knowledge on factors facilitating or challenging IPC uptake and sustainment.
Main Methods:
- Narrative review of literature published since 2000.
- Searches conducted in PubMed, MEDLINE, and CINAHL in May 2022.
- Included studies focused on IPC in neonatal care and reported implementation determinants.
Main Results:
- Organizational-level factors were most frequently reported as relevant to IPC implementation.
- Key determinants included staffing levels, workload, and organizational culture (communication, leadership).
- The Consolidated Framework for Implementation Research was used to categorize determinants.
Conclusions:
- Understanding factors influencing neonatal IPC is crucial.
- This knowledge can guide the design, implementation, and evaluation of IPC practices.
- Implementation science approaches can address challenges in neonatal IPC programs.
Background:
The most prevalent infections encountered in neonatal care are healthcare-associated infections. The majority of healthcare-associated infections are considered preventable with evidence-based infection prevention and control (IPC) practices. However, substantial knowledge gaps exist in IPC implementation in neonatal care. Furthermore, the knowledge of factors which facilitate or challenge the uptake and sustainment of IPC programmes in neonatal units is limited. The integration of implementation science approaches in IPC programmes in neonatal care aims to address these problems.
Objectives:
The aim of this narrative review was to identify determinants which have been reported to influence the implementation of IPC programmes and best practices in inpatient neonatal care settings.
Sources:
A literature search was conducted in PubMed, MEDLINE (Medical Literature Analysis and Retrieval System Online) and CINAHL (Cumulative Index to Nursing and Allied Health Literature) in May 2022. Primary study reports published in English, French, German, Spanish, Portuguese, Italian, Danish, Swedish or Norwegian since 2000 were eligible for inclusion. Included studies focused on IPC practices in inpatient neonatal care settings and reported determinants which influenced implementation processes.
Content:
The Consolidated Framework for Implementation Research was used to identify and cluster reported determinants to the implementation of IPC practices and programmes in neonatal care. Most studies reported challenges and facilitators at the organizational level as particularly relevant to implementation processes. The commonly reported determinants included staffing levels, work- and caseloads, as well as aspects of organizational culture such as communication and leadership.
Implications:
The presented knowledge about factors influencing neonatal IPC can support the design, implementation, and evaluation of IPC practices.
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