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Updated: Jun 15, 2025
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Published on: September 30, 2020
The Multiple Determinants of Infection Prevention and Control Practices in Nursing Homes: A Scoping Review
Kanako Fujimoto1, Momoe Utsumi2, Toshiyuki Swa3
1Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Okayama, Okayama, Japan.
Objectives:
To map the barriers and facilitators influencing infection prevention and control (IPC) practices in nursing homes (NHs) from a behavior change perspective and to identify research gaps.
Design:
Scoping review using the Joanna Briggs Institute methodology.
Setting And Participants:
NHs for older adults and health care workers in NHs.
Methods:
We conducted database searches in March 2022 and updated them in November 2024, including additional sources from citation tracking and reference list checks. We analyzed barriers and facilitators using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation-Behavior (COM-B) model.
Results:
Of 1591 identified records, 54 reports published between 2003 and 2024 met our inclusion criteria. The analysis identified 101 determinants (25 in Capability, 46 in Opportunity, and 30 in Motivation within the COM-B model) categorized into 36 categories and 16 themes as barriers and facilitators. The most frequently mentioned barriers were related to the "Environmental context and resources" domain of the TDF. Relatively few reports addressed the determinants of the TDF domain classified within the Motivation area of the COM-B model. Although many facilitators were identified in this area, including beliefs, intentions, and goals, they were coded based on limited descriptions.
Conclusions And Implications:
This review provides a detailed mapping of the barriers and facilitators to IPC in NHs based on existing literature. It demonstrates the complexity of sustaining IPC practices, influenced by multiple determinants. Although Motivation may impact IPC adherence, its determinants remain insufficiently studied, indicating a research gap. Further research is needed to explore these determinants and understand how Motivation interacts with other factors in IPC implementation.
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