Barriers and Facilitators to Effective Outbreak Management and Key Learnings from the Experience of COVID-19 in Long-Term Residential Care Facilities: A Scoping Review

Background/Objectives: Long-term residential care facilities for older people were particularly vulnerable to outbreaks during the COVID-19 pandemic due to the unique challenges these facilities face. This scoping review synthetizes international literature on barriers and facilitators to the prevention and management of outbreaks in long-term residential care facilities, identifying priorities for future pandemic preparedness. Methods: A comprehensive search was conducted in PubMed, MEDLINE (Ovid), Web of Science Core Collection, Scopus, and CINAHL databases, and English language articles published since 2019 were retrieved. The records were screened against the eligibility criteria by independent reviewers. A qualitative content analysis was performed. Results: The search identified 3222 records, of which 323 pieces of literature were included. Following the synthesis of the available evidence, the barriers and facilitators for prevention and management of outbreaks in long-term residential care facilities were mapped and presented under the following themes: 1) Infection prevention and control challenges and response to the pandemic, 2) The built environment of nursing homes, 3) Staffing of long-term residential care facilities, 4) Leadership and staff resilience, 5) Support and guidance during the pandemic. Conclusions: The findings from this scoping review highlight the necessity of adopting a comprehensive, integrated, and multidisciplinary approach to ensure preparedness and planning for future pandemics. The prevention and control of infectious disease outbreaks within long-term residential care facilities present unique challenges that require the implementation of integrated health and care systems. It is essential to develop response plans that address all critical elements of long-term residential care.