Factors shaping cleaning and disinfection practices during the COVID-19 pandemic: A qualitative evidence synthesis.

Background: Cleaning and disinfection of the physical environment is important as it can reduce the transmission of microorganisms. However, adherence to cleaning and disinfection protocols varies due to factors such as personal factors and external influences like resource availability, workload, and institutional support. Aim: To synthesise factors influencing the uptake of cleaning and disinfection interventions in healthcare and community setting in the context of COVID-19. Setting: These findings as seen in any country irrespective of setting. Method: Medline and World Health Organization (WHO) COVID-19 Research databases were searched from January 2020 to September 2022. The search identified 1618 studies, and analysis was performed using the thematic synthesis approach. The confidence in each review finding was ascertained using the Grading of Recommendations, Assessment, Development, and Evaluations-Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach. Results: Six analytical themes were identified. Cleaning and disinfection were seen as a cornerstone of patient care. Individual judgement, historic standards, norms and practices, ability to implement rapid practice guideline change and resource considerations were seen to influence the uptake of cleaning. Conclusion: There is a need for further qualitative studies in these areas, especially looking at the different interventions from an equity lens. Resource needs and availability were key factors influencing the uptake of cleaning and disinfection in both communities and health facilities. Contribution: This review shows important considerations for implementing infection prevention and control (IPC) interventions in the context of COVID-19.