Samenvatting

Aim(s): To evaluate the effects of a multifaceted de-implementation strategy (RENEW) on the volume (time in minutes) of care spent by home-based nursing care teams on three widely used low-value nursing practices: (1) ‘washing the client with water and soap by default’ & ‘washing the client from head to toe daily’, (2) ‘application of zinc cream, powders or pastes when treating intertrigo’ and (3) ‘assisting with putting on/taking off compression stockings while the client can do this him/herself (possibly with an aid)’. Design: A multicenter, quasi-experimental study using a multiple interrupted time series design. Methods: The RENEW-strategy with components on education, persuasion, enablement, incentives and training was introduced in 31 Dutch home-based nursing care teams from two healthcare organisations. Data was collected before and after the implementation of the strategy (two before and three post measurements). For each team a separate Auto Regressive Integrated Moving Average model was fitted, looking for a difference in the underlying trend over time. The effect of the RENEW-strategy was based on a meta-analysis of the team effects using a weighted inverse-variance approach and stratified for the three low-value home-based nursing care
practices.