Facilitators and barriers for implementing infection prevention interventions in long-term care: a scoping review

Infection prevention and control (IPC) is essential to reduce healthcare-associated infections in long-term care facilities (LTCFs). Its implementation faces unique challenges and is less studied than in acute care. This scoping review mapped barriers and facilitators to IPC implementation in LTCFs.

Standardized procedures for scoping reviews were followed (eg, PRISMA-ScR). PubMed, Web of Science, CINAHL and PsycINFO were searched (2008-2025). Out of 965 articles, 21 studies were included. Data were charted and mapped to the (sub)domains of the Consolidated Framework for Implementation Research (CFIR).

Studies covered nursing homes, pediatric care, and disability care facilities in North America (n = 11), Europe (n = 8), Australia (n = 2) and Asia (n = 1). Most focused on hand hygiene and healthcare staff. Barriers and facilitators were identified across five CFIR domains. Intervention characteristics: Complex, untailored guidelines hindered use, while concise, context-specific protocols and adequate supplies enhanced adherence. Individual characteristics: Knowledge gaps, low risk perception, and competing priorities reduced adherence, whereas motivation, outbreak experience, and professional responsibility supported compliance. Inner setting: Staff shortages, high workload, and limited leadership were major barriers, while managerial engagement, supportive culture, and IPC champions promoted success of IPC. Outer setting: Limited policy support constrained implementation, whereas collaboration with public health agencies and peer networks facilitated it. Implementation process: limitations were lack of structured approaches; but ongoing training, peer feedback, and evaluation were key facilitators.

Many barriers and facilitators towards IPC in LTCFs were identified that can inform future implementation strategies. Implementation processes were rarely considered and need attention in research and practice.