Abstract:

Objective To construct a list of low-value care items for critically ill patients based on evidence-based evidence，so as to provide a reference for the de-implementation of low-value care items in critically ill patients. Methods Systematic searches were conducted in Chinese and English databases，and guidelines related websites，with the search time limit from January 1，2015，to March 1，2025. Two researchers independently performed quality evaluation，extracted and summarized the nursing items explicitly not recommended in the literature. A list of low-value items in critical care was formed through two rounds of expert consultation. Results A total of 26 literatures was included，including 10 guidelines，1 evidence summary，and 15 expert consensuses. The effective response rates of the two rounds of consultation questionnaires were 88.89% and 100%，respectively，with expert authority coefficients of 0.897 and 0.925. The Kendall’s concordance coefficients for item importance were 0.247 and 0.394（P < 0.05）. Finally，60 low-value care items were formed. Conclusion The list of low-value care items for critically ill patients constructed based on evidence-based evidence can guide critical care staff to reduce the implementation of related items in their work，improve nursing quality，and avoid resource waste.

Key words: Critically Ill Patients, Low-Value Care, Summary of the Evidence, Delphi Technique, De-Implementation