189 Effects of de-implementation strategies aimed at reducing low-value nursing procedures 6 Conclusions Most controlled and uncontrolled studies with a positive significant effect used a de-implementation strategy with an educational component (educational meetings, educational materials, educational outreach visits, and/ or educational games) and focused their de-implementation strategy at reducing the use of restraints. Unfortunately, no conclusions can be drawn about which strategy is most effective for reducing low-value nursing. Future studies are needed that assess whether deimplementation strategies that fully connect their strategy towards influencing factors and match their strategy to the target action (stop, replace, reduce, restrict the low-value nursing procedure) are more effective for de-implementation. In order to improve future appraisal of available evidence on de-implementation strategies in nursing we recommend that future studies should report the results on the change in the volume of low-value nursing procedures more extensively and should perform a process evaluation.
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