Journal Club Article

Glarcher, M., Ferguson, C., Patch, M., Steven, A., & Vaismoradi, M. (2024). Strategic de-implementation: strengthening patient safety by eliminating low value care practices. Contemporary Nurse, 1-5.

Low-Value Care:

“There is a discrepancy between evidence-based care and the everyday challenges faced by healthcare professionals.This discrepancy highlights the need to address ineffective care, minimise harm, and maximise the efficacy of healthcare interventions”

Strategies for de-implementation of low-value practices:

1. Removing
2. Replacing
3. Reducing
4. Restricting

Culture of Change:

“Regardless of which type of intervention is used, the aim should be to change the behavior of healthcare professionals based on well-proven theories, or frameworks.”

The challenge in nursing is how to balance mandatory practices, such as completing and documenting the many safety focused screening tools and providing evidence based practice. Generic standardised safety approaches across an array of clinical settings may also not be appropriate to suit the needs of particular patient populations.

Opportunities:

Audit and research initiatives for nurses to examine, assess, and challenge low- value and ineffective practices is highlighted. With the need identified for collaboration across interdisciplinary professions, for regular audit and feedback mechanisms to identify and de-implement low-value care.

Additional Resources:

Nursing Education Network. (2017). Deimplementation of Practice.

Nursing Education Network. (2017).Diffusion of Innovations.