177 Effects of de-implementation strategies aimed at reducing low-value nursing procedures 6 Description of intervention strategy (sorted by EPOC Taxonomy) Positive Significant effect (p≤ 0.05) (Yes/No) Educational meetings: Education about alternatives to indwelling catheters and routine catheter care Education about the protocol Didactic education encompassed routine catheter maintenance, bedside bladder ultrasound indications, and criteria in the nurse-driven protocol. Simulation education to assess proficiency in using the bladder ultrasonography was provided to nurses by the clinical leaders and charge nurses Audit and Feedback: Compliance monitoring to ensure adherence to the protocol and guidelines for routine catheter care Analysis of identified CAUTIs Daily catheter rounds to assess the need for catheter continuation Clinical guidelines: Evidence-based, nurse-driven protocol for urinary catheter management Local consensus processes Protocol approval by NSICU stakeholders No Educational meetings: Formal and informal information sessions for all levels of nursing staff about the restraint and seclusion policy as well as the hospital’s philosophy regarding restraint use. A local vendor demonstrated restraint alternatives Training on proper use of the devices Educational outreach visits: Consultation rounds of a clinical nurse specialist Audit and feedback: The nurses’ adherence to the plan of care was monitored and reviewed during the ongoing consultation rounds, at which time individual nurse-to-nurse feedback was provided The quality management department provided aggregate data in the form of monthly run charts for fall rates and physical restraint use on each unit Local consensus processes: The administrative component involved gaining the active support of the director of nursing, nurse managers, patient care coordinators, physician leaders, and therapists prior to implementation of the program / Educational meetings: Education by occupational therapists. The occupational therapists on the project unit completed a 3-day course and a 1-day workshop with the rest of the staff four months later Sensory modalities for the patient: Access to a variety of sensory modalities located in the unit and a sensory room No Educational meetings: The standards of care for the treatment of a viral upper respiratory tract infections were presented to the individual healthcare provider Audit and feedback: Thirty randomly selected charts coded by the individual healthcare providers Individual provider and group statistics regarding rates of prescribing. No Educational meetings: Lectures Group discussion Demonstration on some types of physical restraint and proper use of physical restraint Three video demonstrations Yes
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