Deimplementation in Clinical Practice: What Are We Waiting For?

Reducing the risk of nasogastric tube misplacement

“…The process of first identifying, then removing, ineffective and possibly harmful interventions from the scope of practice is deemed "deimplementation" of those practices. 22 De implementation of unsafe and unnecessary practices when implementing evidencebased practices is a challenge to many long-standing traditions passed down through generations of nurses. Use of auscultation is and has been a part of nursing "tradition," but patient safety can't and shouldn't knowingly be put at risk with practices that have been demonstrated to be unsafe.…”

“…The process of unlearning requires consideration of both automatic and reflective cognition when introducing and designing deimplementation strategies to bring about the desired changes. 22,[25][26][27] Brown and colleagues identified key perceived barriers to implementing evidence-based practices to be a lack of time and nursing autonomy. 24 Respondents to the 2022 study by Northington and colleagues indicated that the practice of auscultation is overall unacceptable but may be considered appropriate or feasible in the premature and neonatal populations.…”

“…In conjunction with the dissemination of evidence-based practice is removal of traditional and nonevidential practice for NG tube location verification, such as auscultation and aspiration. The process of first identifying, then removing, ineffective and possibly harmful interventions from the scope of practice is deemed “deimplementation” of those practices 22. Deimplementation of unsafe and unnecessary practices when implementing evidence-based practices is a challenge to many long-standing traditions passed down through generations of nurses.…”

“…Replacing auscultation with evidence-based methods represents the new learning that occurs with eventual recession of the traditional method. The process of unlearning requires consideration of both automatic and reflective cognition when introducing and designing deimplementation strategies to bring about the desired changes 22,25-27…”