Low-value wound care: Are nurses and physicians choosing wisely? A mixed methods study.

Area of Science:

• Healthcare quality improvement
• Evidence-based practice in wound care

Background:

• Choosing Wisely promotes reducing unnecessary medical care.
• A key recommendation is that less wound care can be better.

Purpose of the Study:

• Evaluate adherence to Choosing Wisely acute wound care recommendations by Dutch nurses and physicians.
• Identify barriers and facilitators impacting adherence to these guidelines.

Main Methods:

• Mixed-methods study combining surveys and interviews.
• Survey data collected from 171 nurses and 71 physicians (Nov 2017-Feb 2018).
• Interviews conducted with 17 nurses and 6 physicians.

Main Results:

• Awareness of recommendations varied (62%-89% nurses, 46%-85% physicians).
• Non-adherence reported by up to 15% of nurses and 28% of physicians.
• Barriers included lack of knowledge, work environment, and patient preference perceptions; facilitators were attention, cost-consciousness, and open culture.

Conclusions:

• Awareness of Choosing Wisely recommendations does not guarantee adherence.
• Successful implementation requires tailored strategies beyond increased awareness.
• Addressing knowledge deficits and modifying the work environment are crucial for improving adherence.