On Low-Value Nursing Care: Part 1, Why De-implementation Matters for Quality Care

SEVENTEEN YEARS to translate research into practice. This lag has long been cited as the amount of time before new science is adopted into practice.²  More recently, the lag has been downgraded—but only to 15 years.³  In addition to this research-to-practice gap, Garrow⁴  estimated that of 2500 treatments with good evidence, 15% were beneficial, 22% likely beneficial, 7% partially beneficial/harmful, 5% unlikely beneficial, 4% likely ineffective or harmful, with the remaining effectiveness unknown. These quality and safety outcomes underscore the importance of Choosing Wisely—campaigns launched in the United States,⁵  Canada,⁶  Denmark,⁷  and Australia.⁸  These campaigns highlight how some practices become entrenched in everyday routines; such practices are commonly referred to as “sacred cows,” “tradition-based,” or “low-value.”^5–9  This problem is not unique to nursing. Overuse of health care services is recognized worldwide, from medications, screening and diagnostic tests, and therapeutic procedures...