Exemplars Illustrating De-implementation of Tradition-Based Practices.

Clinical practice must be based on evidence. When evidence suggests that a certain practice may be ineffective or even harmful, that practice should be discontinued. The Choosing Wisely campaign, an initiative of the ABIM (American Board of Internal Medicine) Foundation, is intended to bring attenti...

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Publicado en:Critical Care Nurse Vol. 39; no. 6; pp. 64 - 70
Autor principal: Upvall, Michele J.
Formato: CEU tables/charts Journal Article
Publicado: American Association of Critical-Care Nurses Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2019
      vid: 39
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      pub: American Association of Critical-Care Nurses
      place: Alisa Veijo, California
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        10.4037/ccn2019534
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        atl: Exemplars Illustrating De-implementation of Tradition-Based Practices.
      aug:
        au: Upvall, Michele J.
        affil: Clinical nurse specialist for critical care, South Seminole Hospital, Longwood, Florida
      sug:
        subj:
          Critical Care Nursing Administration
          Medical Practice, Evidence-Based
          Implementation Science
          Change Management
          Education, Continuing (Credit)
          Clinical Exemplars
          Outdated Practice
          Bathing and Baths Equipment and Supplies
          Bacterial Contamination
          Cross Infection Prevention and Control
          Strategic Planning
          Decision Making, Clinical
          Gastrointestinal Motility
          Occlusive Dressings
          Patient Centered Care
      ab: Clinical practice must be based on evidence. When evidence suggests that a certain practice may be ineffective or even harmful, that practice should be discontinued. The Choosing Wisely campaign, an initiative of the ABIM (American Board of Internal Medicine) Foundation, is intended to bring attention to tradition-based practices, or "sacred cows," which lack evidence to support their ongoing use. The complex process of discontinuing or reducing the use of tradition-based practices is known as "de-implementation." Recognizing the importance of de-implementation is necessary to fully understand evidence-based practice. This article explores the de-implementation process, examining its barriers and facilitators. Three critical care exemplars of tradition-based practices are presented and examined through the lens of de-implementation. Barriers and facilitators related to de-implementing these tradition-based practices are described, with an emphasis on the roles of various stakeholders and the need to overcome cognitive dissonance and psychological bias.
      pubtype: Academic Journal
      doctype:
        CEU
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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