title: Evaluation of conceptual frameworks applicable to the study of isolation precautions effectiveness.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Discussion paper.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Columbia University School of Nursing, Center for Health Policy, New York, New York, USA.
authors.forename: Catherine Crawford
authors.identifier: http://orcid.org/0000-0001-7100-1535
authors.initials: CC
authors.lastname: Cohen
authors.affiliation: Columbia University School of Nursing, New York, New York, USA.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Shang
mesh_terms: D003428:Cross Infection / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009732:Nursing Care / Q000379:methods; D017063:Outcome Assessment, Health Care; D010356:Patient Isolation / Q000379:methods*; D011787:Quality of Health Care
keywords: barrier precautions; conceptual analysis; contact precautions; cross-contamination; healthcare-associated infection; infection control; infection prevention; nursing; patient isolation; theoretical models