Balanced informational feedback as part of an implementation/deimplementation bundle to support deimplementation efforts in antimicrobial stewardship: results from a mixed methods, hybrid type III implementation/effectiveness trial

Background

Effective de-implementation approaches to reduce low-value or harmful care are limited. Prolonged antimicrobial use after skin closure is ineffective and increases harm but is nonetheless common following cardiovascular implantable electronic device (CIED) procedures. The aim of this quasi-experimental Implementation/Effectiveness study was to use an implementation/de-implementation (I/D) bundle of strategies to promote de-implementation of guideline-discordant prolonged antimicrobial use and improve outcomes.