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- Title
Exemplars Illustrating De-implementation of Tradition-Based Practices.
- Authors
Upvall, Michele J.
- Abstract
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.
- Subjects
CROSS infection prevention; BATHS; GASTROINTESTINAL motility; INTENSIVE care nursing; MEDICAL practice; OCCLUSIVE surgical dressings; STRATEGIC planning; EVIDENCE-based medicine; DECISION making in clinical medicine; OBSOLESCENCE; NARRATIVE medicine; CHANGE management; CONTINUING education units; PATIENT-centered care; BACTERIAL contamination
- Publication
Critical Care Nurse, 2019, Vol 39, Issue 6, p64
- ISSN
0279-5442
- Publication type
Article
- DOI
10.4037/ccn2019534