The Consolidated Framework for Implementation Research: a reflection on researchers' experiences of its benefits and challenges and the lessons learnt from using it.

BACKGROUND: In healthcare implementation research, there is little discussion of researchers' experiences of using frameworks, including the Consolidated Framework for Implementation Research (CFIR). AIM: To identify and discuss the benefits and challenges encountered and the lessons learnt from researchers' experiences of using the CFIR in different contexts and phases of research. DISCUSSION: This article synthesises the reflections of nursing and public health researchers on their experiences of using the CFIR across four separate healthcare-associated infection prevention and control implementation studies. The CFIR's benefits and challenges, the resolutions to these challenges and the lessons learnt from the application of the framework were discussed. CONCLUSIONS: Identified benefits included the framework's adaptability and flexibility, and its provision of structure and shared language for research. Translation to another language and differentiating between domains and constructs were challenges. IMPLICATIONS FOR PRACTICE: Nurse researchers may find this article useful when considering use of the CFIR, or to anticipate and prepare to overcome the challenges highlighted when using the framework.

Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare.

BACKGROUND: The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. AIM: To evaluate the impact of ABHR volume, application time, rubbing friction and hand size on microbiological load reduction, hand surface coverage or drying time. METHODS: Medline, CINAHL, Web of Science and ScienceDirect databases were searched for healthcare or laboratory-based primary studies, published in English, (1980- February 2021), investigating the impact of ABHR volume, application time, rubbing friction or hand size on bacterial load reduction, hand coverage or drying time. Two reviewers independently performed data extraction and quality assessment. The results are presented narratively. FINDINGS: Twenty studies were included in the review. Categories included: ABHR volume, application time and rubbing friction. Sub-categories: bacterial load reduction, hand size, drying time or hand surface coverage. All used experimental or quasi-experimental designs. Findings showed as ABHR volume increased, bacterial load reduced, and drying times increased. Furthermore, one study showed that the application of sprayed ABHR without hand rubbing resulted in significantly lower bacterial load reduction than poured or sprayed ABHR with hand rubbing (- 0.70; 95%CI: - 1.13 to - 0.28). Evidence was heterogeneous in application time, volume, technique, and product. All studies were assessed as high risk of bias. CONCLUSIONS: There is insufficient evidence to change WHO recommendation of a palmful of ABHR in a cupped hand applied for 20-30 s or manufacturer-recommended volume applied for about 20 s (Centers for Disease Control and Prevention). Future hand hygiene research should standardise volume, application time, and consider hand size.

The Consolidated Framework for Implementation Research: a reflection on researchers' experiences of its benefits and challenges and the lessons learnt from using it.

BACKGROUND: In healthcare implementation research, there is little discussion of researchers' experiences of using frameworks, including the Consolidated Framework for Implementation Research (CFIR). AIM: To identify and discuss the benefits and challenges encountered and the lessons learnt from researchers' experiences of using the CFIR in different contexts and phases of research. DISCUSSION: This article synthesises the reflections of nursing and public health researchers on their experiences of using the CFIR across four separate healthcare-associated infection prevention and control implementation studies. The CFIR's benefits and challenges, the resolutions to these challenges and the lessons learnt from the application of the framework were discussed. CONCLUSIONS: Identified benefits included the framework's adaptability and flexibility, and its provision of structure and shared language for research. Translation to another language and differentiating between domains and constructs were challenges. IMPLICATIONS FOR PRACTICE: Nurse researchers may find this article useful when considering use of the CFIR, or to anticipate and prepare to overcome the challenges highlighted when using the framework.