Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review
BACKGROUND: Despite impressive reductions in infectious disease burden within Sub-Saharan Africa SSA) half of the top ten causes of poor health or death in SSA are communicable illnesses. With emerging and re-emerging infections affecting the region the possibility of healthcare-acquired infections HAIs) being transmitted to patients and healthcare workers especially nurses is a critical concern. Despite infection prevention and control IPC) evidence-based practices EBP) to minimize the transmission of HAIs many healthcare systems in SSA are challenged to implement them. The purpose of this review is to synthesize and critique what is known about implementation strategies to promote IPC for nurses in SSA.
METHODS: The databases PubMed Ovid/Medline Embase Cochrane and CINHAL were searched for articles with the following criteria: English language peer-reviewed published between 1998 and 2018 implemented in SSA targeted nurses and promoted IPC EBPs. Further 6241 search results were produced and screened for eligibility to identify implementation strategies used to promote IPC for nurses in SSA. A total of 61 articles met the inclusion criteria for the final review. The articles were evaluated using the Joanna Briggs Institute’s JBI) quality appraisal tools. Results were reported using PRISMA guidelines.
RESULTS: Most studies were conducted in South Africa n = 18 30%) within the last 18 years n = 41 67%) and utilized a quasi-experimental design n = 22 36%). Few studies n = 14 23%) had sample populations comprising nurses only. The majority of studies focused on administrative precautions n = 36 59%). The most frequent implementation strategies reported were education n = 59 97%) quality management n = 39 64%) planning n = 33 54%) and restructure n = 32 53%). Penetration and feasibility were the most common outcomes measured for both EBPs and implementation strategies used to implement the EBPs. The most common MAStARI and MMAT scores were 5 n = 19 31%) and 50% n = 3 4.9%) respectively.
CONCLUSIONS: As infectious diseases especially emerging and re-emerging infectious diseases continue to challenge healthcare systems in SSA nurses the keystones to IPC practice need to have a better understanding of which in what combination and in what context implementation strategies should be best utilized to ensure their safety and that of their patients. Based on the results of this review
Barrera-Cancedda A. E. R. K. A. Shinnick J. E. Buttenheim A. M. 2019). Implementation strategies for infection prevention and control promotion for nurses in Sub-Saharan Africa: a systematic review. Implement Sci141) 111. doi:10.1186/s13012-019-0958-3