Evaluation of conceptual frameworks applicable to the study of isolation precautions effectiveness

Abstract

Aims: A discussion of conceptual frameworks applicable to the study of isolation precautions effectiveness according to Fawcett and DeSanto-Madeya's (2013) evaluation technique and their relative merits and drawbacks for this purpose. Background: Isolation precautions are recommended to control infectious diseases with high morbidity and mortality, but effectiveness is not established due to numerous methodological challenges. These challenges, such as identifying empirical indicators and refining operational definitions, could be alleviated though use of an appropriate conceptual framework. Design: Discussion paper. Data sources: In mid-April 2014, the primary author searched five electronic, scientific literature databases for conceptual frameworks applicable to study isolation precautions, without limiting searches by publication date. Implications for nursing: By reviewing promising conceptual frameworks to support isolation precautions effectiveness research, this article exemplifies the process to choose an appropriate conceptual framework for empirical research. Hence, researchers may build on these analyses to improve study design of empirical research in multiple disciplines, which may lead to improved research and practice. Conclusion: Three frameworks were reviewed: the epidemiologic triad of disease, Donabedian's healthcare quality framework and the Quality Health Outcomes model. Each has been used in nursing research to evaluate health outcomes and contains concepts relevant to nursing domains. Which framework can be most useful probably depends on whether the study question necessitates testing multiple interventions, concerns pathogen-specific characteristics and yields cross-sectional or longitudinal data. The Quality Health Outcomes model may be slightly preferred as it assumes reciprocal relationships, multi-level analysis and is sensitive to cultural inputs.