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A Tailored De-Implementation Strategy to Reduce Low-Value Home-Based Nursing Care: A Mixed-Methods Feasibility Study
Benjamin Wendt1,2, Minke S Nieuwboer2,3, Hester Vermeulen1,2
1Radboud Institute for Health Sciences, IQ Health, Radboud University Medical Center, Nijmegen, The Netherlands.
Journal of Advanced Nursing
|November 14, 2024
Summary
The RENEW strategy significantly reduced low-value nursing care time in home healthcare. This multifaceted de-implementation approach proved acceptable, implementable, cost-effective, and scalable for improving care delivery.
Area of Science:
- Nursing Care Quality
- Healthcare Management
- Implementation Science
Background:
- Low-value care in nursing reduces efficiency and patient outcomes.
- Effective strategies are needed to de-implement unnecessary nursing interventions in home-based settings.
Purpose of the Study:
- To evaluate the RENEW strategy's impact on reducing low-value nursing care.
- To assess the acceptability, implementability, cost-effectiveness, and scalability of RENEW in home-based nursing.
Main Methods:
- Mixed-methods design involving seven home-healthcare teams.
- Quantitative analysis of care frequency and time (minutes/week) pre- and post-intervention.
- Qualitative analysis of semi-structured interviews and documents to identify influencing factors.
Main Results:
- Statistically significant reduction in time spent on low-value nursing care (17.94%).
- Non-significant reduction in the frequency of low-value nursing care.
- Identified 79 influencing factors, with practical tools, coaching, and experience sharing being key.
Conclusions:
- The RENEW strategy effectively reduces low-value nursing care in home healthcare.
- RENEW is conditionally acceptable, implementable, cost-effective, and scalable with minor modifications.
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