Supervised toothbrushing programmes in England: a national survey of current provision and factors influencing their implementation

BDJ, Год журнала: 2025, Номер unknown

Опубликована: Янв. 17, 2025

Язык: Английский

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Investigating the implementation of infection prevention and control practices in neonatal care across country income levels: a systematic review

Antimicrobial Resistance and Infection Control, Год журнала: 2025, Номер 14(1)

Опубликована: Фев. 7, 2025

Abstract Background Despite the proven effectiveness of infection prevention and control (IPC) practices in reducing healthcare-associated infections related costs, their implementation poses a challenge neonatal care settings across high-income (HICs) low- middle-income countries (LMICs). While existing research has predominantly focused on assessing clinical these care, aspects concerning remain underexplored. This systematic review therefore aimed to analyze determinants employed strategies for implementing IPC inpatient country income levels. Methods Following targeted search seven databases, titles abstracts as well full texts were screened dual process identify studies focusing reporting and/or strategies. Implementation synthesized using updated Consolidated Framework Research. coded according Expert Recommendations Implementing Change taxonomy. A convergent integrated approach was used narratively summarize results qualitative quantitative studies. χ 2 Tests Fisher’s Exact performed differences The quality included assessed Mixed Appraisal Tool. Results Out 6,426 records, total 156 review. Neonatal units LMICs HICs showed general commonalities reported determinants, which mainly at organizational level. educational evaluative iterative most frequently support both HICs, other variance Notably, statistical analyses identified significant association between levels respectively ( $$\:\rho\:$$ <0.05). Conclusion this underscore importance level irrespective However, further is needed understand underlying relationships factors dynamics contributing observed practice variances HICs. Registration PROSPERO (CRD42022380379).

Язык: Английский

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JBI's approach to evidence implementation: a 7-phase process model to support and guide getting evidence into practice

JBI Evidence Implementation, Год журнала: 2022, Номер 21(1), С. 3 - 13

Опубликована: Дек. 22, 2022

In this paper, we provide an overview of JBI's approach to evidence implementation and describe the supporting process model that aligns with approach. The central tenets implementing into practice include use evidence-based audit feedback, identification context in which is being implemented, facilitation any change, evaluation process. A pragmatic practical seven-phased outlined assist 'planning' 'doing' getting practice, focusing on clinicians as change agents for clinical policy settings. Further research development required formally evaluate robustness better understand complex nature implementation.

Язык: Английский

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Where is “policy” in dissemination and implementation science? Recommendations to advance theories, models, and frameworks: EPIS as a case example

Implementation Science, Год журнала: 2022, Номер 17(1)

Опубликована: Дек. 12, 2022

Implementation science aims to accelerate the public health impact of evidence-based interventions. However, implementation has had too little focus on role policy - and its inseparable politics, polity structures, policymakers in sustainment healthcare. Policies can serve as determinants, strategies, "thing" be implemented, or another variable causal pathway healthcare access, quality, patient outcomes. Research describing roles dissemination (D&I) efforts is needed resolve persistent knowledge gaps about policymakers' evidence use, how policies are implemented sustained, methods de-implement that ineffective cause harm. Few D&I theories, models, frameworks (TMF) explicitly guide researchers conceptualizing where, how, when should empirically investigated. We conducted reflected results a scoping review identify existing Exploration, Preparation, Implementation, Sustainment (EPIS) framework-guided studies. argue rather than creating new TMF, optimize TMF examine policy's D&I. describe six recommendations help TMF. Recommendations applied EPIS, one example for advancing D&I.(1) Specify dimensions function (policy goals, type, contexts, capital exchanged). (2) form (origin, structure, dynamism, outcomes). (3) Identify define nonlinear phases across outer inner contexts. (4) Describe temporal stakeholders play over time. (5) Consider policy-relevant context adaptations. (6) bridging factors necessary success.Researchers use meaningfully conceptualize practices harmful policies. Applying these advances theoretical knowledge, especially EPIS application, introducing models. Using will sensitize them investigate multifaceted within leading success.

Язык: Английский

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Global Cancer Surgery: pragmatic solutions to improve cancer surgery outcomes worldwide

The Lancet Oncology, Год журнала: 2023, Номер 24(12), С. e472 - e518

Опубликована: Ноя. 2, 2023

Язык: Английский

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Artificial intelligence in physical rehabilitation: A systematic review

Artificial Intelligence in Medicine, Год журнала: 2023, Номер 146, С. 102693 - 102693

Опубликована: Ноя. 2, 2023

Physical disabilities become more common with advancing age. Rehabilitation restores function, maintaining independence for longer. However, the poor availability and accessibility of rehabilitation limits its clinical impact. Artificial Intelligence (AI) guided interventions have improved many domains healthcare, but whether can benefit from AI remains unclear. We conducted a systematic review AI-supported physical technology tested in setting to understand: 1) technology; 2) effect; 3) barriers facilitators implementation. searched MEDLINE, EMBASE, CINAHL, Science Citation Index (Web Science), CIRRIE (now NARIC), OpenGrey. identified 9054 articles included 28 projects. solutions spanned five categories: App-based systems, robotic devices that replace restore gaming systems wearables. randomised controlled trials (RCTs), which evaluated outcomes relating activity, pain, health-related quality life. The effects were inconsistent. Implementation literacy, reliability, user fatigue. Enablers greater access programmes, remote monitoring progress, reduction manpower requirements lower cost. Applications are growing field, yet be studied rigorously. Developers must strive conduct robust evaluations real-world appraise post implementation experiences.

Язык: Английский

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Bridging Treatment Implementation Gaps in Patients With Heart Failure

Journal of the American College of Cardiology, Год журнала: 2023, Номер 82(6), С. 544 - 558

Опубликована: Июль 31, 2023

Язык: Английский

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Why it is hard to use PROMs and PREMs in routine health and care

BMJ Open Quality, Год журнала: 2023, Номер 12(4), С. e002516 - e002516

Опубликована: Дек. 1, 2023

Patient-reported outcome measures (PROMs) and patient-reported experience (PREMs) show the results of healthcare activities as rated by patients others. Patients or their proxies record feedback using questionnaires. These can enhance quality for all tailored care individuals. This paper describes obstacles that inhibit widespread use PROMs PREMs some potential solutions. Implementation is a prerequisite any innovation to succeed. Health services are complex people need be engaged at every level. Most cautious about proven innovations such but champions leaders help them engage. The NASSS framework (reasons Non-adoption, Abandonment failure Scale up, Spread Sustain digital health innovations) helps indicate implementation why it may resisted. Plan-Do-Study-Act (PDSA) approach aids ensure everyone knows who should do what, when, where, how why. Noise an under-appreciated problem, especially when tracking over time before after treatment. Interoperability with electronic records Fast Resources internationally accepted coding schemes SNOMED CT LOINC. projects multiple meet needs involved. Measure selection focus on relevance, ease use, response rates. If these problems avoided mitigated, deliver better patient outcomes, experience, staff satisfaction equity.

Язык: Английский

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A pragmatic context assessment tool (pCAT): using a Think Aloud method to develop an assessment of contextual barriers to change

Implementation Science Communications, Год журнала: 2023, Номер 4(1)

Опубликована: Янв. 11, 2023

The Consolidated Framework for Implementation Research (CFIR) is a determinant framework that can be used to guide context assessment prior implementing change. Though few quantitative measurement instruments have been developed based on the CFIR, most assessments using CFIR relied qualitative methods. One challenge translate conceptual constructs which are often described highly abstract, technical language into lay clear, concise, and meaningful. purpose of this paper document methods develop freely available pragmatic tool (pCAT). pCAT designed frontline quality improvement teams as an abbreviated local facilitators barriers in clinical setting.Twenty-seven interviews Think Aloud method (asking participants verbalize thoughts they respond questions) were conducted with employees improve pilot version pCAT. Interviews recorded transcribed verbatim; guided coding analyses.Participants identified several areas where needed modified, clarified, or allow more nuance increase usefulness employees. Participants found it easier questions when had recent, specific project mind. Potential tend unique each improvement. also missing concepts conflated, leading refinements made understandable, accurate, useful.The practical, everyday familiar short (14 items), available, does not require research expertise experience. It draw knowledge individuals their own context. has online approximately two years generated relatively high level interest indicating potential tool.

Язык: Английский

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Achieving health equity through conversational AI: A roadmap for design and implementation of inclusive chatbots in healthcare

PLOS Digital Health, Год журнала: 2024, Номер 3(5), С. e0000492 - e0000492

Опубликована: Май 2, 2024

Background The rapid evolution of conversational and generative artificial intelligence (AI) has led to the increased deployment AI tools in healthcare settings. While these promise efficiency expanded access services, there are growing concerns ethically, practically terms inclusivity. This study aimed identify activities which reduce bias make their designs implementation more equitable. Methods A qualitative research approach was employed develop an analytical framework based on content analysis 17 guidelines about use clinical stakeholder consultation subsequently conducted with a total 33 ethnically diverse community members, designers, industry experts relevant health professionals further roadmap for equitable design healthcare. Framework interview data. Results 10-stage developed outline phases: 1) Conception planning, 2) Diversity collaboration, 3) Preliminary research, 4) Co-production, 5) Safety measures, 6) testing, 7) Healthcare integration, 8) Service evaluation auditing, 9) Maintenance, 10) Termination. Discussion We have made specific recommendations increase AI’s equity as part services. These emphasise importance collaborative involvement patient groups navigating technologies. Further must assess impact recommended chatbots’ fairness ability inequalities.

Язык: Английский

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