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Keywords

clinical nurse specialist, deimplementation, evidence-based practice, fecal occult blood tests (FOBTs), gastrointestinal bleeding, redesign

 

Authors

  1. Danesh, Valerie PhD, RN, CCRP, CCRN-K
  2. Gisi, Brittany BSN, RN
  3. Narayan, Maitreyi BS
  4. Yoder, Linda PhD, MBA, RN, AOCN, FAAN
  5. Zad, Omid MD

Abstract

Purpose/Objectives: The purpose of this program was to deimplement the use of fecal occult blood tests (FOBTs) for hospitalized patients.

 

Description of the Project/Program: We used a multipronged multidisciplinary approach to deimplement the use of FOBT, including physician-nurse collaborations, data-based poster displays, and a review of test utilization and patient cost throughout all facilities.

 

Outcome: Despite a downward trend in FOBT orders for hospitalized patients over 3 years, the inappropriate use of FOBT remains a cause of unnecessary delays of diagnostic workups and patient care and excess costs ranging from US $22 000 to $41 000 annually for each hospital.

 

Conclusion: Clinical nurse specialists can question the empirical origin and patient outcomes associated with clinical practice and are positioned to assess and champion deimplementation processes.