Background: Enterovirus infection poses a significant and recurrent public health challenge in Taiwanese preschool and childcare settings. While numerous studies address knowledge gaps, there is a lack of synthesized evidence identifying common practice errors and the multi-level factors influencing childcare personnel's infection control behaviors from a systemic perspective.

Objective: This narrative review aims to synthesize empirical and policy literature to systematically map the principal categories of infection control errors, identify their multilevel influencing factors, and provide actionable implications for enterovirus prevention in early childhood settings.

Methods: A systematic literature search was conducted across multiple databases, including PubMed, Scopus, ERIC, and Taiwan’s National Digital Library of Theses, spanning January 2010 to December 2024. A total of 21 studies and official reports were included in the final synthesis.

Results: Three principal categories of infection control errors were identified among childcare personnel: insufficient hand hygiene and environmental cleaning, delayed symptom recognition and reporting, and inconsistent adherence to institutional procedures. These errors are shaped by interacting factors across three levels: individual (e.g., knowledge and self-efficacy), organizational (e.g., staffing and resource constraints), and sociocultural (e.g., parental cooperation and cultural norms). 

Conclusion: These findings underscore that effective enterovirus control requires interventions targeting not only individual knowledge but also addressing structural and relational barriers. The review recommends standardized, sustained training, the implementation of clear and simple protocols, and policy adjustments to optimize staffing and support parental involvement.

Enterovirus infections Infection control, Childcare personnel, Practice gaps