Identifying barriers and enablers to effective infection prevention and control in residential aged care: A qualitative study using the Theoretical Domains Framework
Authors:
- Tropea, Joanne
- Gilbert, Jacqueline
- Bennett, Noleen
- Lim, Lyn-li
- Buising, Kirsty L.
- Fetherstonhaugh, Deirdre
- Kwong, Jason C.
- Johnson, Douglas F.
- Marshall, Caroline
- Flynn, Madelaine
- Yates, Paul A.
- Aboltins, Craig
- Lim, Wen K.
- Peters, Sanne
Details:
American Journal of Infection Control, Volume 54, Issue 1, 2026-01-31
Article Link: Click here
Background Infection prevention and control (IPC) practices are crucial in residential aged care homes (RACHs), yet gaps between evidence-based recommendations and what is done in practice (called evidence-practice gaps) continue. Understanding barriers and enablers to implementing evidence-based IPC is essential for improvement. This study aims to identify barriers and enablers to RACH staff performing evidence-based IPC practices, according to the Theoretical Domains Framework (TDF), and map these domains to associated behavior change techniques (BCTs) to inform interventions. Methods Semi-structured interviews were conducted with 28 staff from 9 RACHs in Victoria, Australia. Interviews explored 7 prioritized IPC evidence-practice gaps. The TDF guided data collection and analysis. Key domains were mapped to BCTs. Results Key enablers included knowledge of IPC importance, access to equipment and resources, skills and experience, self-confidence, visual cues, and beliefs about protecting self and others. Main barriers were related to environmental context and resources, including limited access to hand hygiene products and personal protective equipment. Social influences and competing priorities also posed challenges. The BCTs mapping suggested strategies to improve environmental setup, education, and infrastructure. Conclusions RACH staff reported engagement with evidence-based IPC, highlighting its importance. Barriers mainly related to environmental and resource factors. Recommended strategies based on BCTs offer actionable, resource-efficient interventions to improve IPC practice in RACHs.