Infection Control Elements and Determinants across the Chain of Infection in Korean Long-Term Care Facilities: An Integrative Review

Purpose: This study aimed to identify key infection control elements and analyze intervention strategies across the stages of the chain of infection framework in long-term care facilities in South Korea.Methods: An integrative review was conducted of 25 domestic studies published between 2008 and 2024, including quantitative, qualitative, and mixed-methods research. The selected studies were analyzed according to the six stages of the chain of infection and were categorized into eight major infection control factors.Results: The stages of “mode of transmission” and “susceptible host” were most frequently addressed in the reviewed studies, whereas the “infectious agent,” “reservoir,” “portal of exit,” and “portal of entry” stages received comparatively less attention. Notably, studies focusing on the prevention and management of chronic infections, such as multidrug-resistant organisms, were scarce. Among the eight infection control factors, “education” and “guidelines” consistently emerged as core interventions across all stages. In addition, the findings underscored the importance of deploying dedicated personnel, improving facility, environments, implementing simulation-based training, and strengthening education on aseptic techniques.Conclusion: By applying the chain of infection model, this study reconstructed infection control strategies in long-term care facilities and identified stage-specific gaps in existing interventions. The findings provide practical implications for strengthening infection prevention systems and offer foundational evidence to support policy initiatives, including the deployment of infection control nurses, development of tailored training programs, and reinforcement of national-level infection control guidelines.