American Academy of Nursing Announces Five New Recommendations for the Choosing Wisely Campaign

Academy list now includes 25 commonly used treatment approaches that are not always necessary or advisable

Washington, D.C. –– The American Academy of Nursing announced five new Choosing Wisely recommendations today concerning often routine treatment approaches that may not always be necessary or even in the best interest of patients.

The Choosing Wisely campaign is an initiative of the ABIM Foundation to encourage conversations between patients and their health care professionals about what care is genuinely necessary. The American Academy of Nursing joined Choosing Wisely in 2014, and has worked since then to engage in conversations with a broad coalition of stakeholder groups and individuals to identify nursing practices that the evidence demonstrates are unnecessary, are done frequently and/or are costly, and may be harmful.

The Academy leads the nursing profession’s efforts through recommendations developed by its Choosing Wisely Task Force, composed of member fellows who are leaders of professional nursing organizations (see parentheses below) representing a broad range of clinical expertise, practice settings and patient populations.

The five new recommendations include:

  • Don’t routinely use graduated compression stockings in surgical patients as mechanical prophylaxis for preventing venous thromboembolism (VTE) after surgery, but do consider using intermittent pneumatic compression devices. (American Academy of Nursing Expert Panel on Acute & Critical Care/Munn Center for Nursing Research, Institute for Patient Care, Massachusetts General Hospital)
  • Don’t apply continuous cardiac-respiratory or pulse oximetry monitoring to children and adolescents admitted to the hospital unless condition warrants continuous monitoring based on objectively scored cardiovascular, respiratory, and behavior parameters. (Society of Pediatric Nurses)
  • Don’t routinely repeat labs hemoglobin and hematocrit in the hemodynamically normal pediatric patients with isolated blunt solid organ injury. (American Pediatric Surgical Nurses Association, Inc./American Pediatric Surgical Association)
  • Don’t use physical or chemical restraints, outside of emergency situations, when caring for long-term care residents with dementia who display behavioral and psychological symptoms of distress; instead assess for unmet needs or environmental triggers and intervene using non-pharmacological approaches as the first approach to care whenever possible. (American Academy of Nursing Expert Panel on Aging)
  • Don’t remove hair at the surgical site including the hair on the patient’s head, but if hair must be removed it should be clipped not shaved. (Association of periOperative Registered Nurses /American Association of Nurse Anesthetists/American Association of Neuroscience Nurses)

“The Academy is excited to unveil this new set of statements for the Choosing Wisely campaign, which brings our total list of recommendations to 25,” said Academy President Karen Cox, PhD, RN, FAAN. “We are grateful to our Academy expert panels, and supporting professional nursing organizations, for identifying additional examples of overuse that are consistent with the principles of Choosing Wisely. These statements are meant to start a conversation between the patient and the clinician on which procedures are, or are not, truly necessary in a given situation.”

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The American Academy of Nursing ( 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 2,500 fellows are nursing’s most accomplished leaders in education, management, practice, and research. They have been recognized for their extraordinary contributions to nursing and healthcare.

About the ABIM Foundation

The mission of the ABIM Foundation is to advance medical professionalism to improve the health care system. We achieve this by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policymakers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit, connect on Facebook or follow on Twitter.

About Choosing Wisely

First announced in December 2011, Choosing Wisely is part of a multi-year effort led by the ABIM Foundation to support and engage physicians in being better stewards of finite health care resources. Participating specialty societies are working with the ABIM Foundation to share the lists widely with their members and convene discussions about the physician’s role in helping patients make wise choices.

Barry Eisenberg