American Association of Critical-Care Nurses as part of the Critical Care Societies Collaborative has identified five practices in critical care it believes should be questioned. The creation of the list is part of the ABIM Foundation's "Choosing Wisely" campaign, which encourages providers to re-examine routine acts of care.
The evidence-based recommendations include:
- Don't order diagnostic tests at regular intervals. Do order diagnostic tests in response to specific clinical questions.
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- Don't transfuse red blood cells in hemodynamically stable, non-bleeding critically ill patients with a hemoglobin concentration greater than 7 mg/dL.
- Don't use parenteral nutrition in adequately nourished critically ill patients within the first seven days of a stay in an intensive care unit.
- Don't deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.
- Don't continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort.
For a PDF of the list, complete with more detailed explanations, click here.
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