Overuse targets for Choosing Wisely: Do emergency physicians and nurses agree?

[...]with the advent of team-based emergency care, including nursing order sets, many targets for overuse reduction in the ED may be more sensitive to the clinical decisions of emergency nursing [6,7]. [...]we sought to examine the utility of applying a previously developed survey to create a local...

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Bibliographic Details
Published in:The American journal of emergency medicine 2017-02, Vol.35 (2), p.306-310
Main Authors: Venkatesh, Arjun K., MD, MBA, MHS, Anderson, April, MD, MPH, Rothenberg, Craig, MPH, Parwani, Vivek, MD, MHA, Schwartz, Ian, MD, Haggan, Jeannie, RN, Sevilla, Mark, RN, Shapiro, Marc, MD
Format: Article
Language:English
Subjects:
Antibiotics
Attitude of Health Personnel
Back pain
Choosing Wisely
Cost Control - methods
Cost Control - standards
Cross-Sectional Studies
Decision Making
Emergency
Emergency medical care
Emergency medicine
Emergency Medicine - economics
Emergency Medicine - standards
Emergency nurses
Emergency Nursing - economics
Emergency Nursing - standards
Emergency Service, Hospital - economics
Emergency Service, Hospital - standards
Guideline Adherence - statistics & numerical data
Health Care Surveys
Humans
Likert scale
Medical Overuse - economics
Medical Overuse - prevention & control
Medical personnel
NMR
Nuclear magnetic resonance
Nurses
Nursing
Overuse
Patient satisfaction
Patients
Physicians
Quality of Health Care - economics
Quality of Health Care - standards
Studies
Trauma
Urinary tract infections
Urogenital system
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Description
Summary:[...]with the advent of team-based emergency care, including nursing order sets, many targets for overuse reduction in the ED may be more sensitive to the clinical decisions of emergency nursing [6,7]. [...]we sought to examine the utility of applying a previously developed survey to create a local Choosing Wisely(TM) "Top 5" list inclusive of all clinicians and to assess provider and nurse agreement on the clinical benefit and actionability of each Choosing Wisely(TM) target (Fig. 1). Nurses rated reductions in nursing performed tasks such as blood cultures in non-critically ill patients, follow-up wound checks and avoidance of unnecessary intravenous medication administration as better targets for intervention while providers rated imaging studies often limited to physician or APP ordering higher.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2016.11.016