Mode
Text Size
Log in / Sign up

Professional and patient factors drive the continued use of low-value care in infection preventionIdentifying the reasons why hospitals use unnecessary infection risks

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Note that professional and context-related factors primarily drive the continued use of low-value infection prevention measures.

This scoping review synthesized 57 studies to identify the determinants of overusing low-value care (LVC) in general infection prevention (IP) measures and non-surgical practices, such as urinary catheter and glove use. The review highlights that 40 studies focused on procedures with infection risk, including 37 on urinary catheter use, while 17 studies addressed general IP measures, including 5 on glove use combined with gowns or aprons.

Findings indicate that the primary determinants of overusing these practices are linked to professional, patient, and inner-context factors. These factors are more frequently associated with the continued use of these practices rather than the successful de-implementation of them. The review notes that many studies described situations of overuse without probing the underlying motivations for such practices.

Several limitations were noted, including the fact that none of the included studies explicitly labeled the practices as LVC and many did not specify criteria to distinguish appropriate from inappropriate use. The findings suggest a need for theory-informed, context-sensitive approaches to develop effective de-implementation strategies. Clinical application is currently limited by the lack of a clear, standardized definition of LVC in existing literature.

Hospitals often use certain tools or practices that can actually increase a patient's risk of infection. These are known as low-value care measures. A review of 57 different studies looked into why these practices, such as using urinary catheters or wearing gloves, continue to be used even when they might not be necessary.

Researchers found that the reasons for using these practices often come from professional habits, patient needs, and the internal environment of the hospital. Most of these factors lead to the continued use of these tools rather than helping doctors stop using them when they aren't needed. The review specifically looked at 37 cases involving urinary catheters and 17 cases regarding general infection prevention measures like glove use.

Because the original studies did not always clearly define what counts as low-value care, it is still hard to pinpoint exactly why these habits stick. The findings suggest that hospitals need more specific, context-sensitive plans to help staff move away from practices that do not help patients but do increase infection risks.

What this means for you:
Professional and patient factors often lead to the continued use of medical practices that increase infection risks.

Common questions

What are some examples of high-risk practices in hospitals?

The review looked at 40 studies regarding procedures with infection risks, specifically focusing on urinary catheter use in 37 of those cases. It also looked at 17 studies on general infection prevention measures, which included glove use in 5 cases and gown or apron use.

Why do hospitals continue to use these risky practices?

The review found that the reasons for using these practices are mostly linked to professional factors, patient factors, and the internal context of the hospital. These factors tend to lead to the continued use of these practices rather than helping to stop them.

What are the limitations of this research?

Not all studies included in the review specifically labeled these practices as low-value care. Additionally, many studies did not clearly define the difference between appropriate and inappropriate use, making it harder to see the specific motivations behind the actions.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
Infection prevention (IP) practices are critical to patient safety. However, some IP measures or care procedures associated with a risk of infection are used inappropriately or excessively. This overuse can be considered low-value care (LVC) as it contributes to potential negative health outcomes for patients, unnecessary healthcare costs, and environmental strain. This scoping review aims to identify determinants of (over)use and de-implementation of LVC general IP measures and non-surgical care practices linked to infection risk in hospitals. We conducted a scoping review following Arksey and O’Malley methodology. A systematic search was performed in OVID/Medline, Embase.com, Elsevier/Scopus, and Ebsco/CINAHL up to January 29-February 2, 2026. Study selection was supported by the artificial intelligence tool ASReview using the SAFE-procedure. Data was charted using a piloted extraction form including type of study, type of LVC practice, and determinants of (over)use or de-implementation. Determinants were categorized according to Augustsson's de-implementation framework. A total of 13,738 records were retrieved of which 57 studies were included. Most included studies were empirical and focused on care procedures with an infection risk (n = 40), predominantly urinary catheter use (n = 37). Other studies addressed general IP measures (n = 17), mainly glove use, sometimes combined with gowns/aprons (n = 5) with two studies also including isolation practices. Across studies, determinants mainly related to professional-, patient-, and inner-context, and were primarily associated with continued (over)use rather than de-implementation. Many studies described situations of (over)use rather than explicitly probing the underlying motivations driving these behaviors. None of the studies explicitly labeled the examined care practices as LVC, and several did not specify criteria that distinguished appropriate from inappropriate use. Current literature on determinants of (over)use and de-implementation in infection prevention focuses predominantly on urinary catheter and glove use, with a strong emphasis on determinants driving (over)use. Systematic study of overuse in infection prevention and subsequent development of effective de-implementation strategies is hindered by studies not clearly defining care practices as LVC. Advancing this field requires more theory informed and context-sensitive approaches to better characterize overuse, identify barriers and facilitators to reduce overuse, and to support the development of targeted de-implementation strategies.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.