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Factors affecting healthcare workers’ compliance with social and behavioural infection control measures during emerging infectious disease outbreaks: Rapid evidence review

Publication date: 

16 Aug 2021


BMJ Open 2021; 11(8):e049857 doi: 10.1136/bmjopen-2021-049857


Brooks SK, Greenberg N, Wessely S, Rubin GJ

Publication type: 



Abstract Objective The 2019–2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission. This review’s aim was to explore the existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with infection control measures among healthcare staff. Methods A rapid evidence review for primary studies relevant to healthcare workers’ compliance with infection control measures. Results Fifty-six papers were reviewed. Staff working in emergency or intensive care settings or with contact with confirmed cases appeared more likely to comply with recommendations. There was some evidence that anxiety and concern about the risk of infection were more associated with compliance, and that monitoring from superiors could improve compliance. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability, perceived difficulty and effectiveness, inconvenience, discomfort and a negative impact on patient care. There were many issues regarding the communication and ease of understanding of infection control guidance. Conclusion We recommend provision of training and education tailored for different occupational roles within the healthcare setting, managerial staff ‘leading by example’, ensuring adequate resources for infection control and timely provision of practical evidence-based infection control guidelines.