Table 2.
Evaluation of three most-cited frameworks applicable to the study of isolation precaution effectiveness
| Evaluation Criteria | Clark (1954) | Donabedian (1966) | Mitchell (1998) |
|---|---|---|---|
| Explication of Origins |
Yes. Desire for increased health promotion and disease prevention to meet patient demands in medicine and dentistry stated. Works of numerous named and ‘unnamed’ authors credited for ‘epidemiologic viewpoint’ as a lens for framework development (Leavell & Clark 1958) |
Yes. Personal experience with individual level physician-client relationship implicated as well as publications for framework development and explication, such as Sheps (1955), among others |
Yes. Influences of the goals of Outcomes Measures and Care Delivery Systems invitational conference and work of Donabedian (1966), Holzemer & Reilly (1995), Wilson and Cleary (1995) acknowledged |
|
Comprehensiveness of Content |
Incomplete. Nursing inputs/interventions not included in model |
Complete. All nursing domains and relational propositions addressed, though not identified as such |
Complete. All nursing domains and relational propositions addressed |
| Logical Congruence |
Yes. Consistent with Reaction World View, person-environment and intervention categories of knowledge |
Yes. Consistent with Reaction World View, outcomes and interventions category of knowledge |
Yes. Consistent with Reciprocal World View, outcomes category of knowledge |
| Generation of Theory |
Yes. Few examples in the literature that use the model to generate nursing theory |
Yes. Numerous nursing publications use this framework to generate testable hypotheses |
Yes. Multiple nursing publications use this framework to generate testable hypotheses |
| Legitimacy |
Mixed. Few examples found of successful hypothesis testing in nursing, inspired creation of adapted nursing model (Reifsnider 1995) |
Mixed. Model has been used to guide nursing research and practice successfully, but has also inspired creation of adapted nursing models (Mitchell et al. 1998, Shield et al. 2014) |
Yes. Successful hypothesis testing published without limitations due to the model |
| Social Utility |
Moderate. No education or skills required. Ability to implement protocols derived from model based on expert opinion (Zastrow 2011, Massanari 1989) |
High. No education or skills required. Ability to implement protocols |
High. No education or skills required. Ability to implement protocols |
| Social Congruence |
Unknown. Usefulness across cultures and geographies not published in nursing |
High. Cross-cultural/diverse geographic application published in nursing research (Chen et al. 2007, Closs & Tierney 1993) |
High. Applied to nursing care among facilities in diverse geographic locations and with diverse patient demographics (Brooks-Carthon et al. 2011, Shang et al. 2014) |
| Social Significance |
High. Versatility of model yields high applicability in diverse subjects and fields |
High. Model is well-integrated into nursing research with high impact on practice |
High. Model directed at nursing outcomes with significant influence |
|
Contributions to Nursing Knowledge and nursing Discipline |
High. Effective organizing framework though few papers identified using this model to generate theory |
High. Breadth of model concepts yield broad applicability in nursing |
High. Model has effectively guided nursing activities such as several report card initiatives |