Challenges to infection control in early communication intervention: A scoping review

Abstract

Background: Personal protective equipment (PPE) and infection prevention and control (IPC) measures are crucial to preventing the spread of coronavirus disease 2019 . This study used a scoping review to investigate the challenges that exist when speech-language therapists (SLTs) use IPC measures for providing early communication intervention (ECI).Objectives: To describe existing, recent literature on PPE and IPC measures used in early intervention through a scoping review (steps 1-5) and to consult local clinicians to investigate how SLTs who provide ECI in South Africa relate to these findings (step 6 of the scoping review).Method: A scoping review was performed which followed the PRISMA-ScR framework. Because of limited literature on PPE and IPC measures used by SLTs in providing ECI, the inclusion criteria were adjusted to include PPE and IPC measures used by healthcare workers (HCWs) who provide early intervention to the population of infants and toddlers up to 3 years old. At the time of the review, articles were not older than 10 years and were published between 2011 and 2020. The scoping review included a consultation with South African SLTs who provide ECI, including during the COVID-19 pandemic. A pilot study was conducted prior to the consultations. Seventeen clinicians were included in total. Data from both the pilot study and main consultation were transcribed and analysed in the results using thematic analysis.Results: Fourteen articles were included in the study. The scoping review of existing literature identified challenges to implementing IPC measures, namely the care and behaviour of young children, infrastructure and system challenges, poor compliance and lack of training and a lack of standard IPC protocols. Clinicians in the consultation phase confirmed these challenges and reported that IPC measures did not consider ECI populations nor the settings in which services were provided. Suggestions from the literature for improved infection control included hand hygiene, improved supplies and infrastructure and education and training. Clinicians in the consultation added practical suggestions for implementing IPC measures within ECI, which included an increase in parent-led intervention as well as cleaning and disinfection strategies. Conclusion:This study identified challenges and recommendations of SLTs who use PPE and IPC measures whilst providing ECI. Understanding these challenges can benefit ECI services and future research efforts focused on improving ECI services whilst maintaining IPC standards.

The impact of COVID-19 on speech–language and hearing professions in low- and middle-income countries: Challenges and opportunities explored

“…Additionally, Karrim et al ( 2022 ) raised challenges with criteria, strategies and technical skills required for the utilisation of telerehabilitation by speech–language therapists and audiologists. For example, challenges were highlighted on telerehabilitation in children with autism spectrum disorder; middle ear assessments (Sebothoma & Khoza-Shangase, 2022 ); therapy for speech, language and swallowing following stroke (Tar-Mahomed & Kater, 2022 ); early communication intervention (Achmat & Gerber, 2022 ); neonatal feeding in neonatal intensive care units (Coutts et al, 2022 ); and geriatric audiology service provision in old age homes (De Andrade & Landman, 2022 ).…”

“…Challenges to practice created by COVID-19 were worsened by access and infrastructure challenges, as well as the related high infrastructural costs. Over and above infrastructure and system challenges directly related to curbing the spread of COVID-19 in the form of personal protective equipment (PPE) and infection prevention and control (IPC) measures (Achmat & Gerber, 2022 ), noteworthy other infrastructure and cost- related challenges were experienced by both professionals and patients (Khoza-Shangase, 2022b ; McAllister et al, 2022 ; Tar-Mahomed & Kater, 2022 ). Access to the technology and its infrastructural support for innovative clinical service provision was raised as a serious barrier.…”

“…Furthermore, as far as challenges to practice are concerned, COVID-19 significantly increased the workload of clinicians (Balton et al, 2022 ; Hlayisi, 2022 ; Khatib & Hlayisi, 2022 ). Over and above the core function of providing clinical care, time devoted to establishing innovative modes of service provision, sourcing required resources that would allow for continuity of service provision during the pandemic, training and upskilling everyone on alternative service provision methods, as well as engagement in the national COVID-19 pandemic management were all added to clinicians’ workloads (Achmat & Gerber, 2022 ; Balton et al, 2022 ; Hlayisi, 2022 ; Karrim et al, 2022 ; Khatib & Hlayisi, 2022 ; Khoza-Shangase, 2022b ; Nagdee et al, 2022 ). Balton et al ( 2022 ) highlighted how such workload challenges were possibly influenced by a lack of or poor application of policies and regulations within the South African context.…”

“…• Not applicable 14. Achmat and Gerber (2022) Challenges to infection control in early communication intervention: A scoping review…”

Quality of TB diagnostic services at primary healthcare clinics in eThekwini district, South Africa

“…Ironically, continuous education can be an effective tool for improving the quality of TB services [ 34 ]. Adequate training has been linked to better implementation of IPC measures, another barrier to quality identified by this study [ 36 ]. Although many facilities adhered to WHO IPC standards by triaging coughing patients and separating them from others [ 37 ], we also found that clinic infrastructure resulted in overcrowded waiting areas and inadequate ventilation; moreover, there was a poor supply of masks/respirators, which led to limited mask use.…”