Nurses Unite Across Texas to Address Overuse

In 2014 the American Academy of Nursing (AAN) joined the Choosing Wisely® campaign and released its first list of things nurses and patients should discuss. To help spread awareness and adoption of its recommendations, AAN began a statewide pilot program in Texas to foster collaboration within the nursing community.

To lead the program, AAN leadership convened a steering committee comprised of volunteers from various organizations, including the Texas Team Action Coalition and Texas Nurses Association (TNA). Committee members network with key stakeholder groups, including insurers, patient advocates, nursing associations, academic leaders and policy groups, to advance Choosing Wisely.

Steering committee member Lisa J. Woodward, DNP, RN, CENP, Vice President, Nursing Education at Doctors Hospital at Renaissance in Edinburg, Texas, said the Choosing Wisely pilot program also aligns with existing state efforts to promote the nursing profession and engage a diverse community, which includes 206,000 registered nurses across several specialties, according to data from the Texas Health Professions Resource Center.

“Providing necessary care by listening and partnering with patients has always been important to practicing nurses,” Dr. Woodward said. “We are the main connection between other health care providers and the patient and family. Choosing Wisely provides evidence to initiate important conversations about appropriate care. We’re going to do the right thing.”

The committee is engaged in the following work as part of the pilot program:

Pre-Survey

The committee worked with the Texas Center for Nursing Workforce Studies on a pre-survey to gauge awareness and attitudes among nurses across the state about Choosing Wisely. The pre-survey, scheduled to be fielded this month, will assess how key messages of the campaign are perceived.

Education

Following the survey, the committee, with support from AAN, will develop a program focused on education during regional and statewide organizational meetings and conferences aimed at nurses. The committee is working to allow nurses to gain credit for Choosing Wisely training through Continuing Nursing Education.

In addition, the committee is working to produce an educational video to inform nurses about Choosing Wisely, relevant campaign recommendations, and examples of how they can incorporate the campaign into practice. While other Choosing Wisely materials focus on the physician and patient perspectives, this will incorporate the entire care team. The video is scheduled to be embedded on different nurse-facing sites across the state this fall, including the Texas Organization of Nurse Executives (TONE), TNA and Texas Team.

Next Steps

The committee will conduct a follow-up survey to measure change in awareness about Choosing Wisely. It will then expand communication and education efforts to target patients and other health care professionals.

As work continues in Texas, AAN will leverage the process and materials developed by the pilot program to help other states implement similar Choosing Wisely initiatives. New Mexico has already expressed interest in adopting its own program.

“It can be a challenge, but nurses have to raise questions about tests and procedures that might not be warranted,” Dr. Woodward said. “The Choosing Wisely recommendations make this task easier because they were created by peers and colleagues. They are a great tool to remind us not to work in silos. The campaign empowers everyone on the care team to collaborate.”