Implementation of infection prevention and control for hospitalised neonates: A narrative review.

BACKGROUND The most prevalent infections encountered in neonatal care are healthcare-associated infections (HAIs). The majority of HAIs are considered preventable by evidence-based infection prevention and control (IPC) practices, but substantial knowledge gaps exist in IPC implementation in neonatal care. Furthermore, knowledge of factors that facilitate or challenge IPC programme uptake and sustainment in neonatal units is limited. The integration of implementation science approaches within IPC programmes in neonatal care aims to address these problems. OBJECTIVES The aim of this narrative review was to identify determinants that 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 and CINAHL in May 2022. Primary study reports published since 2000 in English, French, German, Spanish, Portuguese, Italian, Danish, Swedish, or Norwegian were eligible for inclusion. Included studies focused on IPC practices in inpatient neonatal care settings and reported determinants that 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 organisational level as particularly relevant to implementation processes. Commonly reported determinants included staffing levels, work- and caseloads, as well as aspects of organisational 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.