Upvall Michele J, Bourgault Annette M
College of Nursing, University of Central Florida, Orlando, FL.
Nurs Forum. 2018 Apr 25. doi: 10.1111/nuf.12256.
The purpose of this concept analysis is to explore the meaning of de-implementation and provide a definition that can be used by researchers and clinicians to facilitate evidence-based practice.
De-implementation is a relatively unknown process overshadowed by the novelty of introducing new ideas and techniques into practice. Few studies have addressed the challenge of de-implementation and the cognitive processes involved when terminating harmful or unnecessary practices. Also, confusion exists regarding the myriad of terms used to describe de-implementation processes.
Walker and Avant's method (2011) for describing concepts was used to clarify de-implementation.
A database search limited to academic journals yielded 281 publications representing basic research, study protocols, and editorials/commentaries from implementation science experts. After applying exclusion criterion of English language only and eliminating overlap between databases, 41 articles were selected for review.
Literature review and synthesis provided a concept analysis and a distinct definition of de-implementation.
De-implementation was defined as the process of identifying and removing harmful, non-cost-effective, or ineffective practices based on tradition and without adequate scientific support.
The analysis provided further refinement of de-implementation as a significant concept for ongoing theory development in implementation science and clinical practice.
本概念分析的目的是探讨去实施的含义,并提供一个定义,供研究人员和临床医生用于促进循证实践。
去实施是一个相对鲜为人知的过程,在将新思想和技术引入实践的新颖性面前黯然失色。很少有研究探讨去实施的挑战以及终止有害或不必要实践时涉及的认知过程。此外,用于描述去实施过程的众多术语也存在混淆。
采用沃克和阿凡特(2011年)描述概念的方法来阐明去实施。
对仅限于学术期刊的数据库搜索产生了281篇出版物,代表基础研究、研究方案以及实施科学专家的社论/评论。在应用仅英文的排除标准并消除数据库之间的重叠后,选择了41篇文章进行综述。
文献综述与综合提供了对去实施的概念分析和明确的定义。
去实施被定义为识别并去除基于传统且缺乏充分科学支持的有害、无成本效益或无效实践的过程。
该分析进一步完善了去实施这一概念,使其成为实施科学和临床实践中正在进行的理论发展的一个重要概念。