Implementation of digital and organizational strategies for the prevention of healthcare-associated infections in adult hospitals: a systematic review

Healthcare-associated infections (HAIs) remain a persistent challenge for patient safety and health system performance, despite the availability of evidence-based prevention guidelines. Gaps in real-world implementation and organisational integration within hospital settings continue to limit the effectiveness of infection prevention efforts. This systematic review synthesises evidence on digital, organisational, and hybrid strategies implemented in adult hospitals to prevent HAIs, with a focus on implementation approaches and reported outcomes. A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted for studies published between January 2010 and December 2025. Eligible studies evaluated digital and/or organizational interventions in adult inpatient hospital settings. A structured narrative synthesis was performed due to methodological heterogeneity. 47 studies were included. Digital interventions primarily supported surveillance and feedback processes, organizational strategies commonly supported adherence and standardization, and hybrid approaches frequently reported improvements in both process and infection-related outcomes. However, direct category-level comparisons were absent, and the reported effects varied according to hospital setting, organizational capacity, and implementation context. Successful implementation was commonly associated with leadership support, workflow integration, and organizational readiness. The findings suggest that digital technologies may better support sustained HAI prevention when embedded within organizational workflows and quality improvement structures rather than implemented as standalone solutions. Not applicable.