This article provides a thorough interpretation of the recommendations for implementation research in healthcare-associated infection (HAI) prevention and control, jointly issued by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, and the Association of Professionals in Infection Control and Epidemiology. The recommendations elaborate on the concepts, strategies, determinants, and evaluation methods of implementation research, as well as the commonly used theories, models, and frameworks (TMF) in the field of HAI prevention and control. By expounding on these TMF, this article aims to guide readers in deeply considering the scientific issues related to the implementation of hospital infection prevention and control, and to provide guidance on selecting and applying appropriate resources in specific environments and situations. The release of these recommendations aims to promote the implementation of evidence-based guidelines in medical institutions and ultimately achieve the goal of reducing the incidence of hospital infections by promoting and guiding the conduct of implementation research in the field of HAI prevention and control.
This paper introduces the background, significance, definition and types of clinical audit and describes five stages of clinical audit, including preparing for clinical audit, selecting criteria, measuring performance and sustaining improvement. This paper also introduces the international and national status quo of implementing clinical audit in nursing practice and describes the reporting guideline for articles of clinical audit. Finally, this article suggests that providing methodological training and creating a supportive environment are crucial strategies to promote the implementation of clinical audit and bridge the gaps between evidence and practice.
Guideline implementation with decision support checklist (GUIDES) aims to assist the self-reflection of evidence-based clinical decision support system (CDSS) related professionals to enhance the process monitor and continuous improvement of evidence-based CDSS. This paper interpreted the development process, target user, and assessment method of GUIDES, analyzed the practical value of GUIDES through a typical example, and then reflected on the GUIDES and current studies on evidence-based CDSS in China. It is expected to provide references for future studies.
The covariate-adjusted response-adaptive randomisation (CARA) design combines the advantages of response-adaptive randomisation and covariate-adaptive randomisation, and improves the efficiency and reliability of clinical trials by combining analytical results and covariates and dynamically adjusting the allocation of subsequent patients. This paper describes in detail several methods of CARA design and their example applications of various methods, including the dominant confidence method, the urn model, the generalized linear model, and the Atkinson model, and provides the corresponding R codes in anticipation of a wider application of the provided R codes in clinical trials.
Evidence-based evidence translated into health care services requires three conversion processes, preclinical research-clinical research-implementation research, which might take a very long time. In order to speed up the process of research results translated into daily medical practice and health policy, an effectiveness-implementation hybrid design combining the effectiveness research of clinical and implementation research was emerging. This paper introduced the concept, classification and application of effectiveness-implementation hybrid design, to provide references for researchers in this area.
The consolidated framework for implementation research (CFIR) is one of the most commonly used theoretical frameworks for implementation science. The updated CFIR was optimized based on the original version. The background, process and contents of the updated CFIR were introduced, and the domains and constructs of the updated CFIR were interpreted in this article. We analyzed the similarities and differences of the updated CFIR compared with the original CFIR, in order to provide methodological references for Chinese researchers to explore the determinants of implementation.
Objective
This study was to develop a framework of evidence-based continuous quality improvement and provide a framework for nursing professionals to promote evidence transfer and clinical nursing quality improvement.
Methods
Guided by the principles of PDCA, evidence-based nursing and work process, a framework of evidence-based quality continuous improvement was established through a citation analysis of evidence implementation related projects and literatures.
Results
The framework of evidence-based continuous quality improvement consisted of four stages and twelve steps, including evidence searching, practice audit, evidence implementation and outcome evaluation, and then it would turn to next cycle.
Conclusion
The framework of evidence-based continuous quality improvement provides nursing professionals a concept and method of promoting evidence into practice and promoting clinical nursing quality improvement.
Compared with traditional medical devices, artificial intelligence medical devices face greater challenges in the process of clinical trials due to their related characteristics of artificial intelligence technology. This paper focused on the challenges and risks in each stage of clinical trials on artificial intelligence medical devices for assisted diagnosis, and put forward corresponding coping strategies, with the aim to provide references for the performance of high-quality clinical trials on artificial intelligence medical devices and shorten the research period in China.
The vigorous development of day surgery is crucial to alleviating the contradiction between supply and demand of medical and health care and improving the efficiency of medical and health resources in China. The current path dependence, policy inertia, and lack of coordination in the development of day surgery have brought a more severe test to the healthy and orderly development of day surgery in China, and the vulnerability in the development of day surgery has also emerged gradually. By examining the positive and negative experiences and lessons learned in the current development of day surgery, from the perspective of “structure-resource-information- society” subsystems, and based on the identification of key competencies in the collaborative development system for day surgery, this article indicates that the day surgery resilience is a composite system composed of spatial resilience, digital resilience, resource oriented resilience, institutional resilience and management resilience, and analyzes the implementation path of day surgery collaborative development system, providing a theoretical basis for the healthy and orderly development of day surgery in China.
Effectiveness-implementation hybrid designs can test the effectiveness of interventions and the outcomes of implementation strategies concurrently and accelerate the transformation of research results into routine practice. This paper introduced three types of effectiveness-implementation hybrid designs and corresponding reporting guidelines, including standards for reporting implementation studies, cluster randomized design and CONSORT 2010, stepped-wedge cluster randomized design and extended version CONSORT 2018, qualitative research and COREQ reporting guideline, and provide references for domestic researchers to produce research reports on effectiveness-implementation hybrid design.
