By Roberta Heale, Associate Editor BMJ @EBNursingBMJ #ebnjc @robertaheale
There is a growing trend for overuse of healthcare interventions, including prescriptions and treatments. Choosing Wisely is a global initiative with a mission to improve decision making between health care providers and patients and to decrease the use of unnecessary, or unwarranted tests and treatments. Choosing Wisely encourages discussion with patients related to the following five questions:
- Do I really need this test, treatment or procedure?
- What are the risks or downsides?
- What are the possible side effects?
- Are there simpler, safer options?
- What will happen if I do nothing?
(see Choosing Wisely UK http://www.choosingwisely.co.uk/about-choosing-wisely-uk/)
Health care provider groups can participate in this initiative by developing lists of tests or treatments that are widely used, but have little or no supporting evidence. It isn’t only physician groups with concerns about unwarranted tests or treatments. Appropriate, evidence-based nursing care is essential to optimal patient outcomes and our care deserves evaluation. The Canadian Nurses Association recruited 12 participants to develop a list of nine nursing interventions that “Patients and Nurses Should Question”. Check them out here: http://www.choosingwiselycanada.org/recommendations/nursing/
Choosing Wisely provides a systematic and positive platform for the critique of routine care and these processes have the potential to lead to better implementation of evidence into practice.