8
Models and Frameworks Tables
Table 5. European and Mixed-Methods
• Derived from the Consolidated Framework for Implementation Research (CFIR)
1
• Originated as the InDepth work package, a longitudinal qualitative comparative case
study within the PROHIBIT study,
2
which sought to identify the role contextual
factors play in barriers and facilitators to successful implementation
5
3 qualitative measures of implementation success:
1. Acceptability: Satisfaction with the intervention.
2. Intervention fidelity: Local implementation matched with the stated goals of the
multicenter trial.
3. Adaptation: Local efforts to match the intervention with local context.
Settings that have applied the European and Mixed-Methods framework:
• European institutions of varied healthcare systems and cultures
Improvements using the European and Mixed-Methods framework:
• CLABSI prevention
3
• Hand hygiene
4
1. Consolidated Framework for Implementation Research website. https://cfirguide.org/
2. Sax, H, Clack, L, Touveneau, S, et al. Implementation of infection control best practice in
intensive care units throughout Europe: a mixed-method evaluation study. Implement Sci
2013;8:24.
3. van der Kooi, T, Sax, H, Pittet, D, et al. Prevention of hospital infections by intervention and
training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce
central venous catheter-related bloodstream infections. Intensive Care Med 2018;44:48–60.
4. van der Kooi, T, Sax, H, Grundmann, H, et al. Hand hygiene improvement of individual
healthcare workers: results of the multicentre PROHIBIT study. Antimicrob Resist Infect Control
2022;11:123.
5. Clack, L, Zingg, W, Saint, S, et al. Implementing infection prevention practices across European
hospitals: an in-depth qualitative assessment. BMJ Qual Saf 2018;27:771–780.
