{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:12:55Z","timestamp":1790795575951,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T00:00:00Z","timestamp":1422403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Worldviews Ev Based Nurs"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sacred cows (SC) are old habits in practice, considered routine and above dispute, regardless of evidence to the contrary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This is the first known report that aims to conduct a systematic evaluation of practices that have been described in the literature as SC and strategies for planned implementation of evidence\u2010based practices (EBP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A large, complex, academic medical center department of nursing compared SC to EBP. Nurses systematically reviewed and rated the degree to which current practices adhered to best\u2010evidence versus SC. This initiative, \u201cSacred Cow: Gone to Pasture,\u201d was developed, structured, and implemented according to the Iowa Model of Evidence\u2010Based Practice to Promote Quality Care, as well as Everett Rogers\u2019 Diffusions of Innovations Theory. Implementation of EBP followed a phase plan using the Implementation Strategies for Evidence\u2010Based Practice to help to support adoption and integration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Review of organization\u2010specific policies and procedures and reports of actual practices revealed that SC persist, even in a center internationally recognized as a leader in EBP. The SC initiative caught the attention of busy clinicians, and raised awareness of SC and the importance of adherence to EBP. The SC initiative resulted in policy and practice changes and sparked new EBP and research, resulting in numerous improvements, including a significant decline in catheter\u2010associated urinary tract infections and shifting from basins to commercially prepared cloths for patient bathing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Linking Evidence to Action<\/jats:title><jats:p>A strategic approach is crucial to eliminating SC and integrating EBP. This report calls nurses globally to action, to identify and abandon ineffective healthcare practices. Further research should compare and test the efficacy of implementation strategies, in particular how to sustain EBP in clinical settings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/wvn.12072","type":"journal-article","created":{"date-parts":[[2015,1,28]],"date-time":"2015-01-28T18:19:57Z","timestamp":1422469197000},"page":"3-11","source":"Crossref","is-referenced-by-count":41,"title":["Sacred Cow Gone to Pasture: A Systematic Evaluation and Integration of Evidence\u2010Based Practice"],"prefix":"10.1111","volume":"12","author":[{"given":"Kirsten","family":"Hanrahan","sequence":"first","affiliation":[{"name":"Associate Research Scientist, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Wagner","sequence":"additional","affiliation":[{"name":"Advanced Practice Nurse, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Matthews","sequence":"additional","affiliation":[{"name":"Advanced Practice Nurse, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Stewart","sequence":"additional","affiliation":[{"name":"Advanced Practice Nurse, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Dawson","sequence":"additional","affiliation":[{"name":"Director, Clinical Functions, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Greiner","sequence":"additional","affiliation":[{"name":"Advanced Practice Nurse, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Pottinger","sequence":"additional","affiliation":[{"name":"Infection Preventionist, Clinical Quality, Safety and Performance Improvement, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Vernon\u2010Levett","sequence":"additional","affiliation":[{"name":"Advanced Practice Nurse, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Herold","sequence":"additional","affiliation":[{"name":"Education Director, Heart and Vascular Center, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Hottel","sequence":"additional","affiliation":[{"name":"Advanced Practice Nurse, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Cullen","sequence":"additional","affiliation":[{"name":"Evidence\u2010Based Practice Scientist, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Tucker","sequence":"additional","affiliation":[{"name":"Director, Nursing Research, Evidence\u2010Based Practice and Quality, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Williamson","sequence":"additional","affiliation":[{"name":"Associate Vice President for Nursing, Chief Nursing Officer, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics  Iowa City IA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,1,28]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Application manual, magnet recognition program","author":"American Nurses Credential Center","year":"2008"},{"issue":"1","key":"e_1_2_8_3_1","first-page":"31","article-title":"The sacred cow contest","volume":"89","author":"Brown G. 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