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Zhao P, Ma S, Guo L, Jia Y, Zhang R, Chen M, Wang Z, Liu D, Zhao Y, Wang X, Rong M. Inactivation of microorganisms on fabrics using plasma-activated nebulized mist driven by different plasma gases. JOURNAL OF HAZARDOUS MATERIALS 2024; 471:134365. [PMID: 38669926 DOI: 10.1016/j.jhazmat.2024.134365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/31/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
The disinfection of fabrics is crucial in preventing the spread of infectious diseases caused by pathogenic microorganisms to maintain public health. A previous study proved that plasma-activated nebulized mist (PANM) could effectively inactivate microorganisms both in aerosol and attached to the surface. In this study, the PANM driven by different plasma gases were employed to inactivate microorganisms on diverse fabrics. The PANM could efficiently inactivate a variety of microorganisms, including bacteria, fungi, and viruses, contaminating different fabrics, and even across covering layers of different fabrics. The mites residing on the cotton fabrics both uncovered and covered with various types of fabrics were also effectively inactivated by the PANM. After 30 times repeated treatments of the PANM, notable changes were observed in the color of several fabrics while the structural integrity and mechanical strength of the fabrics were unaffected and maintained similarly to the untreated fabrics with slight changes in elemental composition. Additionally, only trace amounts of nitrate remained in the fabrics after the PANM treatment. Therefore, the PANM treatment supplied an efficient, broad-spectrum, and environmentally friendly strategy for industrial and household disinfection of fabrics.
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Affiliation(s)
- Pengyu Zhao
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Sihong Ma
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Li Guo
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China.
| | - Yikang Jia
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Rui Zhang
- School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Min Chen
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Zifeng Wang
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Dingxin Liu
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Yuan Zhao
- Key Laboratory for Physical Electronics and Devices of the Ministry of Education & Shaanxi Key Lab of Information Photonic Technique, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Xiaohua Wang
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
| | - Mingzhe Rong
- State Key Laboratory of Electrical Insulation and Power Equipment, Center for Plasma Biomedicine, Xi'an Jiaotong University, Xi'an 710049, PR China
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Kern JM, Berger K, Lechner AM, Porsche U, Wallner M, Past EM. Lack of microbiological awareness on the ward as a key factor for inappropriate use of anti-infectives: results of a point prevalence study and user satisfaction survey in a large university hospital in Austria. Infection 2024; 52:995-1008. [PMID: 38150152 PMCID: PMC11143009 DOI: 10.1007/s15010-023-02150-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/27/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE Although diagnostic stewardship issues in clinical microbiology harbor an optimization potential for anti-infective consumption, they are only marginally addressed in antimicrobial stewardship (AMS) programs. As part of an AMS point prevalence (PPS) survey we therefore aimed to gain a more dynamic view on the microbiological awareness within therapeutic regimens. By examining whether initial microbiological sampling was performed and in which way microbiological results were incorporated into further treatment considerations we sought to find out to what extent these points determine the appropriateness of treatment regimens. METHODS PPS was performed at the University Hospital Salzburg (1524 beds) in May 2021. Relevant data was determined from the patient charts and the appropriateness of anti-infective use was assessed using predefined quality indicators. Six months after the PPS, a questionnaire was administered to clinicians to obtain information on the use of microbiological findings and their relevance in the clinic. RESULTS Lack of microbiological awareness in the clinical setting proved to be the key reason for an overall inadequate use of anti-infectives (35.4% of cases rated as inadequate), ahead of the aspects of dose (24.1%), empirical therapy (20.3%) and treatment duration (20.2%). This was particularly the case for broad-acting agents and was most evident in urinary tract infections, skin and soft tissue infections, and pneumonia. The results of the questionnaire indicate a discrepancy between the physicians surveyed and the routine clinical setting. CONCLUSION A high potential in improving the use of anti-infectives in hospitals seems to lie in a strong emphasis on microbiological diagnostic stewardship measures.
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Affiliation(s)
- Jan Marco Kern
- Institute of Clinical Microbiology and Hygiene, Paracelsus Medical Private University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria.
| | - Karoline Berger
- Department of Clinical Pharmacy and Drug Information, State Pharmacy, University Hospital Salzburg, Muellner Hauptstrasse 50, 5020, Salzburg, Austria
| | - Arno Michael Lechner
- Institute of Clinical Microbiology and Hygiene, Paracelsus Medical Private University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Ulrike Porsche
- Department of Clinical Pharmacy and Drug Information, State Pharmacy, University Hospital Salzburg, Muellner Hauptstrasse 50, 5020, Salzburg, Austria
| | - Markus Wallner
- Institute of Clinical Microbiology and Hygiene, Paracelsus Medical Private University, University Hospital Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria
| | - Eva Maria Past
- Department of Clinical Pharmacy and Drug Information, State Pharmacy, University Hospital Salzburg, Muellner Hauptstrasse 50, 5020, Salzburg, Austria
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3
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Marschall J, Snyders RE, Sax H, Newland JG, Guimarães T, Kwon JH. Perspectives on research needs in healthcare epidemiology and antimicrobial stewardship: what's on the horizon - Part I. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e199. [PMID: 38028931 PMCID: PMC10654935 DOI: 10.1017/ash.2023.473] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 12/01/2023]
Abstract
In this overview, we articulate research needs and opportunities in the field of infection prevention that have been identified from insights gained during operative infection prevention work, our own research in healthcare epidemiology, and from reviewing the literature. The 10 areas of research need are: 1) transmissions and interruptions, 2) personal protective equipment and other safety issues in occupational health, 3) climate change and other crises, 4) device, diagnostic, and antimicrobial stewardship, 5) implementation and de-implementation, 6) health care outside the acute care hospital, 7) low- and middle-income countries, 8) networking with the "neighbors", 9) novel research methodologies, and 10) the future state of surveillance. An introduction and chapters 1-5 are presented in part I of the article, and chapters 6-10 and the discussion in part II. There are many barriers to advancing the field, such as finding and motivating the future IP workforce including professionals interested in conducting research, a constant confrontation with challenges and crises, the difficulty of performing studies in a complex environment, the relative lack of adequate incentives and funding streams, and how to disseminate and validate the often very local quality improvement projects. Addressing research gaps now (i.e., in the postpandemic phase) will make healthcare systems more resilient when facing future crises.
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Affiliation(s)
- Jonas Marschall
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
- BJC Healthcare, St. Louis, MO, USA
| | | | - Hugo Sax
- Bern University Hospital, University of Bern, Bern, Switzerland
| | - Jason G. Newland
- Division of Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Thais Guimarães
- Infection Control Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Jennie H. Kwon
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
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4
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Schinas G, Dimopoulos G, Akinosoglou K. Understanding and Implementing Diagnostic Stewardship: A Guide for Resident Physicians in the Era of Antimicrobial Resistance. Microorganisms 2023; 11:2214. [PMID: 37764058 PMCID: PMC10537711 DOI: 10.3390/microorganisms11092214] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Antimicrobial resistance (AMR) poses a significant global health challenge, exacerbated by the COVID-19 pandemic. Antimicrobial stewardship programs (ASPs) are crucial in managing this crisis, with diagnostic stewardship (DS) emerging as a key component. DS refers to the appropriate use of diagnostic tests to optimize patient outcomes, improve antimicrobial use, and combat multi-drug-resistant (MDR) organisms. Despite its potential, understanding and application of DS remain ambiguous in multiple respects, which, however, do not directly implicate the implementation of such initiatives. DS is particularly important for resident physicians who are often at the forefront of patient care and can significantly influence future AMR strategies. This review provides a comprehensive overview of DS, discussing its importance, potential challenges, and future directions. It emphasizes the need for resident physicians to understand DS principles and integrate them into their clinical practice from the beginning of their careers. The review also highlights the role of various stakeholders in implementing DS and the importance of continuous education and training. Ultimately, DS is not just a clinical tool but a philosophy of care, essential for a more responsive, humane, and effective healthcare system.
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Affiliation(s)
| | - George Dimopoulos
- 3rd Department of Critical Care, EVGENIDIO Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Karolina Akinosoglou
- School of Medicine, University of Patras, 26504 Patras, Greece;
- Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, 26504 Patras, Greece
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5
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Santos J, Delaplain PT, Barie PS, Dvorak J, Mele TS, Gelbard R, Guidry CA, Schubl SD. Different Surgeon, Different Closure: Lack of Consensus on Appropriate Closure Technique for Various Case Scenarios. Surg Infect (Larchmt) 2023; 24:541-548. [PMID: 37462905 DOI: 10.1089/sur.2023.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
Background: Many techniques for closure of surgical incisions are available to the surgeon, but there is minimal guidance regarding which technique(s) should be utilized at the conclusion of surgery and under what circumstances. Hypothesis: Management of incisions at the conclusion of surgery lacks consensus and varies among individual surgeons. Methods: The Surgical Infection Society membership was surveyed on the management of incisions at the conclusion of surgery. Several case scenarios were provided to test the influences of operation type, intra-operative contamination, and hemodynamic stability on incision management (e.g., close fascia or skin, use of incision/wound vacuum-assisted closure [VAC] device). Responses by two-thirds of participants were required to achieve consensus. Data analysis by χ2 test and logistic regression, a = 0.05. Response heterogeneity was quantified by the Shannon index (SI). Results: Among 78 respondents, consensus was achieved for elective splenectomy (91% close skin/dry dressing). Open appendectomy and left colectomy/end-colostomy had the greatest heterogeneity (SI, 1.68 and 1.63, respectively). During trauma laparotomy, the majority used damage control for hemodynamic instability (53%-67%) but not for hemodynamically stable patients (0%-1.3%; p < 0.001). Additional consensus was achieved for close skin/dry dressing for hemodynamically stable trauma splenectomy patients (87%) and fascia open/wound VAC for hemodynamically unstable colon resection/anastomosis (67%). Fecal diversion for rectal injury and colon resection/anastomosis (both when hemodynamically stable) had high heterogeneity (SI, 1.56 and 1.48, respectively). In penetrating trauma, sentiment was for more use of wet-to-dry dressings and incision/wound VAC with increased contamination in hemodynamically stable patients. Conclusions: Damage control was favored in hemodynamically unstable trauma patients, with use of wet-to-dry dressings and incision/wound VAC with spillage after penetrating trauma. However, most scenarios did not achieve consensus. High variability of practices regarding incision management at the conclusion of surgery was confirmed. Prospective studies and evidence-based guidance are needed to guide decision making at end-operation.
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Affiliation(s)
- Jeffrey Santos
- Department of Surgery, University of California-Irvine, Orange, California, USA
| | - Patrick T Delaplain
- Department of Surgery, Boston Children's Hospital, Harvard Medical System, Boston, Massachusetts, USA
| | - Philip S Barie
- Division of Trauma, Burns, Acute and Critical Care, Department of Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Justin Dvorak
- Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Tina S Mele
- Divisions of General Surgery and Critical Care, Department of Surgery, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Rondi Gelbard
- Division of Trauma and Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - Christopher A Guidry
- Division of Acute Care Surgery, Department of Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Sebastian D Schubl
- Department of Surgery, University of California-Irvine, Orange, California, USA
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6
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Burnham JP, Kwon JH, Newland JG, McKay VR. Dissemination and implementation science and antimicrobial stewardship in solid organ transplantation: A perspective. Transpl Infect Dis 2022; 24:e13903. [DOI: 10.1111/tid.13903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/08/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jason P. Burnham
- Division of Infectious Diseases Washington University in St. Louis School of Medicine St. Louis Missouri USA
| | - Jennie H. Kwon
- Division of Infectious Diseases Washington University in St. Louis School of Medicine St. Louis Missouri USA
| | - Jason G. Newland
- Department of Pediatrics Washington University in St. Louis School of Medicine St. Louis Missouri USA
| | - Virginia R. McKay
- Brown School at Washington University in St. Louis St. Louis Missouri USA
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7
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Studying Factors Affecting Success of Antimicrobial Resistance Interventions through the Lens of Experience: A Thematic Analysis. Antibiotics (Basel) 2022; 11:antibiotics11050639. [PMID: 35625282 PMCID: PMC9137464 DOI: 10.3390/antibiotics11050639] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 02/06/2023] Open
Abstract
Antimicrobial resistance (AMR) affects the environment, and animal and human health. Institutions worldwide have applied various measures, some of which have reduced antimicrobial use and AMR. However, little is known about factors influencing the success of AMR interventions. To address this gap, we engaged health professionals, designers, and implementers of AMR interventions in an exploratory study to learn about their experience and factors that challenged or facilitated interventions and the context in which interventions were implemented. Based on participant input, our thematic analysis identified behaviour; institutional governance and management; and sharing and enhancing information as key factors influencing success. Important sub-themes included: correct behaviour reinforcement, financial resources, training, assessment, and awareness of AMR. Overall, interventions were located in high-income countries, the human sector, and were publicly funded and implemented. In these contexts, behaviour patterns strongly influenced success, yet are often underrated or overlooked when designing AMR interventions. Improving our understanding of what contributes to successful interventions would allow for better designs of policies that are tailored to specific contexts. Exploratory approaches can provide encouraging results in complex challenges, as made evident in our study. Remaining challenges include more engagement in this type of study by professionals and characterisation of themes that influence intervention outcomes by context.
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8
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Hueth KD, Prinzi AM, Timbrook TT. Diagnostic Stewardship as a Team Sport: Interdisciplinary Perspectives on Improved Implementation of Interventions and Effect Measurement. Antibiotics (Basel) 2022; 11:250. [PMID: 35203852 PMCID: PMC8868553 DOI: 10.3390/antibiotics11020250] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/03/2022] [Accepted: 02/11/2022] [Indexed: 02/06/2023] Open
Abstract
Diagnostic stewardship aims to deliver the right test to the right patient at the right time and is optimally combined with antimicrobial stewardship to allow for the right interpretation to translate into the right antimicrobial at the right time. Laboratorians, physicians, pharmacists, and other healthcare providers have an opportunity to improve the effectiveness of diagnostics through collaborative activities around pre-analytical and post-analytical periods of diagnostic testing. Additionally, special considerations should be given to measuring the effectiveness of diagnostics over time. Herein, we perform a narrative review of the literature on these potential optimization opportunities and the temporal factors that can yield changes in diagnostic effectiveness. Our objective is to inform on these considerations to ensure enhanced value through improved implementation and measurement of effectiveness for local stakeholder metrics and/or clinical outcomes research.
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Affiliation(s)
- Kyle D. Hueth
- BioMérieux, Salt Lake City, UT 84104, USA; (K.D.H.); (A.M.P.)
| | | | - Tristan T. Timbrook
- BioMérieux, Salt Lake City, UT 84104, USA; (K.D.H.); (A.M.P.)
- College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USA
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9
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Abstract
Herpes simplex keratitis, caused primarily by human herpes simplex virus type 1 (HSV-1), remains the most common infectious cause of unilateral blindness and vision impairment in the industrialized world. Major advances in the care of HSV keratitis have been driven in large part by the landmark Herpetic Eye Disease Study randomized clinical trials, which were among the first in ophthalmology to reflect emerging trial conventions, including multicenter subject enrollment, double-masking, placebo controls, and a priori sample size determinations. The results of these trials now form much of the evidence basis for the management of this disease. However, management patterns in clinical practice often deviate from evidence-based care. These perceived quality gaps have given rise to the evolving field of implementation science, which is concerned with the methods of promoting the application of evidence-based medicine within routine care. To overcome variations in the quality and consistency of care for HSV keratitis, a range of clinical- and technology-based innovations are proposed. The most pressing needs include the following: a rational and tractable disease classification scheme that provides an immediate link between the anatomical localization of disease (corneal epithelial, stromal, or endothelial) and the appropriate treatment, and the actualization of an electronic medical record system capable of providing evidence-based treatment algorithms at relevant points of care. The latter would also input data to population-wide disease registries to identify implementation-rich targets for quality improvement, education, and research. These innovations may allow us to reduce the human and economic burdens of this highly morbid, and often blinding, disease.
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10
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Heiden BT, Tetteh E, Robbins KJ, Tabak RG, Nava RG, Marklin GF, Kreisel D, Meyers BF, Kozower BD, McKay VR, Puri V. Dissemination and Implementation Science in Cardiothoracic Surgery: A Review and Case Study. Ann Thorac Surg 2021; 114:373-382. [PMID: 34499861 PMCID: PMC9112075 DOI: 10.1016/j.athoracsur.2021.08.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 07/06/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
Dissemination and implementation (D&I) science is the practice of taking evidence-based interventions (EBI) and sustainably incorporating them in routine clinical practice. As a relatively young field, D&I techniques are underutilized in cardiothoracic surgery. This review offers an overview of D&I science from the context of the cardiothoracic surgeon. First, we provide a general introduction to D&I science and basic terminology that is used in the field. Second, to illustrate D&I techniques in a real-world example, we discuss a case study for implementing lung protective management (LPM) strategies for lung donor optimization nationally. Finally, we discuss challenges to successful implementation that are unique to cardiothoracic surgery and give several examples of EBIs that have been poorly implemented into surgical practice. We also provide examples of successful D&I interventions - including de-implementation strategies - from other surgical subspecialties. We hope that this review offers additional tools for cardiothoracic surgeons to explore when introducing EBIs into routine practice.
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Affiliation(s)
- Brendan T Heiden
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Emmanuel Tetteh
- Brown School of Public Health, Washington University in St. Louis, St. Louis, MO
| | - Keenan J Robbins
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Rachel G Tabak
- Brown School of Public Health, Washington University in St. Louis, St. Louis, MO; Institute for Implementation Science, Washington University in St. Louis, St. Louis, MO
| | - Ruben G Nava
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Gary F Marklin
- Institute for Implementation Science, Washington University in St. Louis, St. Louis, MO
| | - Daniel Kreisel
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Bryan F Meyers
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Benjamin D Kozower
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Virginia R McKay
- Brown School of Public Health, Washington University in St. Louis, St. Louis, MO
| | - Varun Puri
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO.
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11
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Tabak RG, Bauman AA, Holtrop JS. Roles dissemination and implementation scientists can play in supporting research teams. Implement Sci Commun 2021; 2:9. [PMID: 33451364 PMCID: PMC7811259 DOI: 10.1186/s43058-020-00107-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/21/2020] [Indexed: 11/10/2022] Open
Abstract
The field of dissemination and implementation (D&I) science is rapidly growing, with many scientists seeking to apply D&I science to enhance and expand the impact of their work. As the D&I field grows and collaborations of implementation scientists with other fields flourish, a description for the roles for D&I scientists as they collaborate with researchers from other fields could be beneficial. This paper exemplifies how the D&I scientist/researcher collaborative process might work and important elements to consider in doing so, as well as provide an outline on how collaborations might progress for different project needs. This is discussed through example scenarios to consider an implementation scientists' engagement in a research project and describe potential roles for implementation scientists in supporting research teams. We then discuss characteristics to consider when incorporating a D&I expert into a team and considerations in navigating the scenarios.
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Affiliation(s)
- Rachel G Tabak
- Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, USA.
- Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Ana A Bauman
- Brown School of Social Work, Washington University in St. Louis, Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA
| | - Jodi Summers Holtrop
- Department of Family Medicine and Dissemination and Implementation Research Program of the Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Aurora, CO, USA
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12
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Greene M, Myers J, Tan JY, Blat C, O’Hollaren A, Quintanilla F, Hsue P, Shiels M, Hicks ML, Olson B, Grochowski J, Oskarsson J, Havlir D, Gandhi M. The Golden Compass Program: Overview of the Initial Implementation of a Comprehensive Program for Older Adults Living with HIV. J Int Assoc Provid AIDS Care 2020; 19:2325958220935267. [PMID: 32715875 PMCID: PMC7385829 DOI: 10.1177/2325958220935267] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 04/27/2020] [Accepted: 05/26/2020] [Indexed: 12/13/2022] Open
Abstract
The population with HIV is aging and has unique health needs. We present findings from an evaluation of the geriatric-HIV program, Golden Compass, at San Francisco General Hospital. We used the implementation science framework, RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) to guide the evaluation and used quantitative and qualitative methods to assess RE-AIM dimensions. From January 2017 to June 2018, 198 adults age ≥50 years participated in the program, with an estimated reach of 17%. Providers and patients indicated high acceptability of the program and were satisfied with clinics and classes. Colocation of services, specific pharmacy and geriatric assessments, and social support from classes were valued (effectiveness). Provider adoption was high, and the program was implemented as originally designed. Areas for improvement included challenges of framing aging services to patients. Future efforts will focus on expanding the reach of the program and examining long-term outcomes.
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Affiliation(s)
- Meredith Greene
- Division of Geriatrics, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Janet Myers
- Division of Prevention Science, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Judy Y. Tan
- Division of Prevention Science, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Cinthia Blat
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California–San Francisco, San Francisco, CA, USA
| | - Allison O’Hollaren
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Francisco Quintanilla
- Division of Geriatrics, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Priscilla Hsue
- Division of Cardiology, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Mary Shiels
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Mary Lawrence Hicks
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Bill Olson
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Janet Grochowski
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Jon Oskarsson
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Diane Havlir
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, ID and Global Medicine, Department of Medicine, University of California–San Francisco, San Francisco, CA, USA
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