American Academy of Nursing Announces Engagement in National Choosing Wisely® Campaign

As Part of Campaign, The Academy Releases List of Five Commonly Used Treatment Approaches That Are Not
Always Necessary or Advisable 

WASHINGTON DC (October 16, 2014) – The American Academy of Nursing (Academy), an organization dedicated to advancing health policy and practice, today released a list of common health care practices that are not always necessary or in the best interests of patient health.  The list’s release occurs in conjunction with the Academy’s participation in the Choosing Wisely® campaign, an initiative of the ABIM Foundation intended to spur conversations between health care professionals and patients about what care is genuinely necessary.

The Academy’s recommendations are supported by extensive health evidence and reviewed by Academy fellows who are among the nursing profession’s most accomplished leaders. “The Academy is committed to leading the nursing professions’ efforts in the Choosing Wisely campaign.  We applaud the ABIM Foundation’s campaign and the effort to promote meaningful and evidence-based conversations between providers and patients about the best course of treatment,” said Academy President Diana Mason.

The Choosing Wisely® initiative, to date, has engaged nearly 100 national and state medical specialty societies, regional health collaborative and consumer organizations and has identified more than 300 tests and procedures that have been described as overused and inappropriate and should be discussed with patients.

“The American Academy of Nursing is among the first non-physician organizations to release a list as part of the Choosing Wisely® campaign. This represents an important milestone for the effort, as patients rely on the trusted voice of nurses to help them navigate a world filled with increasingly complex health information,” said Daniel Wolfson, executive vice president and chief operating officer for the ABIM Foundation. “The new Choosing Wisely list from the Academy will serve as a guide for conversations between patients, nurses and all members of the care team in identifying the best course of care for each individual patient.”

The AAN Choosing Wisely® recommendations include:

• Don’t automatically initiate electronic fetal heart rate monitoring for low-risk women during labor.  Evidence does not support routine use of continuous monitoring among women with low-risk pregnancies.  Such monitoring has been associated with an increase in cesarean and instrumental births, without an associated improvement in perinatal outcomes.

• Don’t let older adults lie in bed or only get up into a chair during their hospital stay.  Walking while in the hospital is critical for maintaining functional ability.  For years, bed rest was thought to be essential in overcoming illness or injury, but evidence shows a lack of walking increases the length of hospital stays and the need for rehabilitation services while elevating the risk of falling after being discharged.

• Don’t use physical restraints with an older hospitalized patient.  Currently, older patients are restrained in hospitals at a much higher rate than other adults.  Restraints do not keep people safe from falls and injuries and have a negative impact on physical, psychological and recovery outcomes.

• Don’t wake patients from sleep for routine care unless the patient’s condition or care specifically requires it.  There is a long-standing perception that patient safety requires patient assessment and monitoring at pre-determined intervals around the clock.  Studies, however, show that sleep deprivation negatively affects cognitive function, the ability to perform physical activities and ventilator, circulatory, immunologic, hormonal and metabolic stability.

• Don’t place or maintain a urinary catheter in a patient unless there is a specific reason for doing so.  Catheter-associated urinary tract infections are among the most common healthcare-associated infections in the U.S. and most are related to the use of urinary catheters.

“Nurses spend more time with patients in most settings and are the most trusted profession in the eyes of the public.  This positions nurses to have conversations with the public about the best practices that promote health and healing while reducing unnecessary costs and care.  As an organization of nursing leaders, we are positioned to take these practices to impact education, clinical practice and public policy.  We look forward to doing this important work.” said Karen Cox, Chair of the Academy’s Choosing Wisely initiative and Executive Vice President/Co-Chief Operating Officer Children’s Mercy Hospitals, Kansas City.

About the American Academy of Nursing

The American Academy of Nursing (www.AANnet.org) serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy’s more than 2,300 fellows are nursing’s most accomplished leaders in education, management, practice, and research. They have been recognized for their extraordinary contributions to nursing and health care.