Evidence map›Paper›PMID 39920866›Full record

SynthesisAntimicrobial resistance and infection control2025

Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review.

Emanuela Nyantakyi, Julia Baenziger, Laura Caci, Kathrin Blum, Aline Wolfensberger, Angela Dramowski, Bianca Albers, Marta Castro, Marie-Therese Schultes, Lauren Clack

Abstract readSystematic Review
In one paragraph

Synthesis in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Emanuela NyantakyiMedical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland. emanuela.nyantakyi@uzh.ch.ORCID 0000-0002-7740-7680
Julia BaenzigerMedical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0001-9121-4423
Laura CaciMedical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0002-0572-4214
Kathrin BlumMedical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0002-4383-0528
Aline WolfensbergerMedical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0001-9028-0007
Angela DramowskiDepartment of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 8000, South Africa.ORCID 0000-0002-0161-9791
Bianca AlbersMedical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0001-9555-0547
Marta CastroCentre of Clinical Nursing Science, University Hospital Zurich, Zurich, 8091, Switzerland.ORCID 0009-0005-4556-850X
Marie-Therese Schultes *Medical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0002-1593-3247
Lauren Clack *Medical Faculty, Institute for Implementation Science in Health Care, University of Zurich, Zurich, 8006, Switzerland.ORCID 0000-0002-5162-5188

Funding

H2020 Societal Challenges 965328
6 · The paper itself

Abstract

backgroundDespite the proven effectiveness of infection prevention and control (IPC) practices in reducing healthcare-associated infections and related costs, their implementation poses a challenge in neonatal care settings across high-income (HICs) and low- and middle-income countries (LMICs). While existing research has predominantly focused on assessing the clinical effectiveness of these practices in neonatal care, aspects concerning their implementation remain underexplored. This systematic review therefore aimed to analyze implementation determinants and employed strategies for implementing IPC practices in inpatient neonatal care across country income levels.

methodsFollowing a targeted search in seven databases, titles and abstracts as well as full texts were screened in a dual review process to identify studies focusing on the implementation of IPC practices in inpatient neonatal care and reporting on implementation determinants and/or implementation strategies. Implementation determinants were synthesized using the updated Consolidated Framework for Implementation Research. Implementation strategies were coded according to the Expert Recommendations for Implementing Change taxonomy. A convergent integrated approach was used to narratively summarize results across qualitative and quantitative studies. χ

resultsOut of 6,426 records, a total of 156 studies were included in the systematic review. Neonatal units in LMICs and HICs showed general commonalities in reported implementation determinants, which were mainly reported at the organizational level. While educational as well as evaluative and iterative strategies were most frequently employed to support the implementation of IPC practices in both LMICs and HICs, other strategies employed showed variance across country income levels. Notably, the statistical analyses identified a significant association between country income levels and implementation determinants and strategies respectively ([Formula: see text]<0.05).

conclusionThe results of this systematic review underscore the importance of the organizational level for the implementation of IPC practices in neonatal care irrespective of country income level. However, further research is needed to understand the underlying relationships of factors and dynamics contributing to the observed practice variances in LMICs and HICs. REGISTRATION: PROSPERO (CRD42022380379).

Indexed as

Cross InfectionInfection ControlDeveloping CountriesHumansIncomeInfant, NewbornImplementation Science Systematic Literature ReviewInfection, Healthcare AssociatedInfection PreventionNeonatal UnitNeonate

Identifiers

PMID39920866
PMCPMC11806577

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.