A Realistic Evaluation of Intermediaries in Infection Control Practice:Investigating and Understanding Context

Williams, L. and Rycroft-Malone, J. and Burton, C.R. (2010) A Realistic Evaluation of Intermediaries in Infection Control Practice:Investigating and Understanding Context. In: Knowledge Utilisation Colloquium, 2010-06-012010-06-01.

Abstract

Background: This study will provide a realistic evaluation of the functions of individuals widely recognized as ‘intermediaries’ (Milner et al, 2004). The study’s conceptual framework is informed by the idea that evidence-informed practice is influenced by context (Rycroft-Malone et al, 2004). However, conceptualizing context can be problematic when exploring complex programmes. It is argued that within a realistic evaluation approach, the definition of context requires more clarity to establish precisely how it is being utilized (Greener & Mannion, 2009). Aim: The aim of this poster presentation is to identify how a theoretical framework can improve understanding of contextual issues. The evaluation will determine how (and whether) context mediates the role and function of the intermediary in infection control. Methods: As a theory-driven approach, the use of realistic evaluation will enable an in- depth exploration of the complex interplay between the intermediary and contextual factors (including policy and organizational influences) that shape their impact on infection control outcomes. Archer’s (1995) framework follows a morphogenetic approach to studying processes affecting structure in social systems, and places emphasis on considering the past as an influencing force for realist researchers (McEvoy & Richards, 2003). Archer’s (1995) framework labels the relationship between stakeholders within policy contexts based on policy theorizing, and offers ‘situation logics’ which help to understand the implications of using or introducing certain mechanisms (Greener & Mannion, 2009). Results: Findings of the study should explain the functions and influences of intermediaries in infection control.By using Archer’s framework to consider the impact of past and present policy theory in infection control, it should be possible to generate a better understanding of the role of context in explaining what works for whom and where in clinical practice.