Exploring the role of healthcare personnel in designing Tuberculosis Infection Prevention and Control measures in healthcare settings: A scoping review

Abstract

Background Healthcare personnel (HCP) in high TB burdened countries continue to be at high risk of occupational TB due to inadequate implementation of Tuberculosis Infection Prevention and Control (TB-IPC) measures, lack of understanding of the context and relevance to local settings. Such transmission in the healthcare workplace has prompted the development and dissemination of numerous guidelines for strengthening TB-IPC for use in settings globally. However, a growing body of literature points to lack of involvement of the HCP in the conceptualization and development of guidelines and programmes seeking to improve TB-IPC in high burden countries generally. Objectives The aim of this study is to identify factors affecting and influencing the adoption of TB-IPC measures in heath settings and the recognised research field exploring the inclusion of the HCP in decision making when designing these guidelines, in relation to appropriateness of the guidelines to the local context. Methods A scoping review methodology was selected for this study to gain insight into the relevant research evidence identifying and mapping key elements in the TB-IPC measures in relation to HCP as implementors. Results Studies in this review refer to factors related to HCP’s knowledge of TB-IPC, perception regarding occupational risks, behaviours, and their role against a background of structural resource constraints, and guidelines adherence. They report several challenges in the TB-IPC implementation and adherence particularly eliciting recommendations from HCP for improved TB-IPC practices. Conclusion Research on the enablers and barriers to TB-IPC implementation needs to go beyond mere documenting factors affecting and influencing adoption of TB-IPC measures in heath settings. There is an urgent need for research on participation of the implementers in the decision making when developing TB-IPC guidelines. Finally, when designing the TB-IPC guidelines, factors to be considered should be the appropriateness of the guidelines to the local context.