Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/52498
DISSEMINATION INTERVENTIONS TO IMPROVE HEALTHCARE WORKERS’ ADHERENCE WITH INFECTION PREVENTION AND CONTROL GUIDELINES: A SYSTEMATIC REVIEW AND META-ANALYSIS
Acute respiratory tract infections
Clinical practice guideline
Guideline adherence
Implementation strategies
Implementation outcomes
Health personnel
Controle de Infecções
Síndrome Respiratória Aguda Grave
Ciência da Implementação
Pessoal de Saúde
Author
Affilliation
University of Sorocaba. Pharmaceutical Science Graduate Course. São Paulo, SP, Brazil.
University of Campinas. Faculty of Pharmaceutical Science. Campinas, SP, Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
University of Brasilia. Faculty of Ceilândia. Brasília, DF, Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
University of Campinas. Faculty of Pharmaceutical Science. Campinas, SP, Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
University of Brasilia. Faculty of Ceilândia. Brasília, DF, Brazil.
Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
Abstract
Background: The COVID-19 pandemic has challenged health systems worldwide since 2020. At the frontline of
the pandemic, healthcare workers are at high risk of exposure. Compliance with infection prevention and control
(IPC) should be encouraged at the frontline. This systematic review aimed to assess the effects of dissemination
interventions to improve healthcare workers’ adherence with IPC guidelines for respiratory infectious diseases in the
workplace.
Methods: We searched CENTRAL, MEDLINE, Embase, and the Cochrane COVID-19 Study Register. We included randomized controlled trials (RCTs) and cluster RCTs that assessed the effect of any dissemination strategy in any healthcare settings. Certainty of evidence was assessed using the GRADE approach. We synthesized data using randomeffects model meta-analysis in Stata 14.2.
Results: We identified 14 RCTs conducted from 2004 to 2020 with over 65,370 healthcare workers. Adherence to IPC
guidelines was assessed by influenza vaccination uptake, hand hygiene compliance, and knowledge on IPC. The most
assessed intervention was educational material in combined strategies (plus educational meetings, local opinion
leaders, audit and feedback, reminders, tailored interventions, monitoring the performance of the delivery of health
care, educational games, and/or patient-mediated interventions). Combined dissemination strategies compared to
usual routine improve vaccination uptake (risk ratio [RR] 1.59, 95% confidence interval [CI] 1.54 to 1.81, moderate-certainty evidence), and may improve hand hygiene compliance (RR 1.70; 95% CI 1.03 to 2.83, moderate-certainty). When
compared to single strategies, combined dissemination strategies probably had no effect on vaccination uptake (RR
1.01, 95% CI 0.95 to 1.07, low-certainty), and hand hygiene compliance (RR 1.16, 95% CI 0.99 to 1.36, low-certainty).
Knowledge of healthcare workers on IPC improved when combined dissemination strategies were compared with
usual activities, and the effect was uncertain in comparison to single strategy (very low-certainty evidence).
Conclusions: Combined dissemination strategies increased workers’ vaccination uptake, hand hygiene compliance,
and knowledge on IPC in comparison to usual activities. The effect was negligible when compared to single dissemination strategies. The adoption of dissemination strategies in a planned and targeted way for healthcare workers may
increase adherence to IPC guidelines and thus prevent dissemination of infectious disease in the workplace.
Keywords
Infection prevention and controlAcute respiratory tract infections
Clinical practice guideline
Guideline adherence
Implementation strategies
Implementation outcomes
Health personnel
DeCS
COVID-19Controle de Infecções
Síndrome Respiratória Aguda Grave
Ciência da Implementação
Pessoal de Saúde
Share