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Related Concept Videos

Ethical Issues01:27

Ethical Issues

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Nurses are essential in patient care, upholding the ethical principles of their profession and effectively navigating ethical dilemmas. Neglecting ethical issues can lead to inadequate patient care, compromised therapeutic relationships, and moral distress among healthcare workers.
Ethical Concerns in Healthcare:
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Critical Thinking I01:24

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Patient-centered Care01:13

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Patient-centered care involves delivering care beyond inpatient hospitalization. Reflective practice can enhance a patient-centered approach. Reflective practice is a process of reasoning that considers all aspects of the present situation, including practicalities, learning from personal practice, and consideration of patient needs. Patients appreciate care decisions made while considering their input. Involving the patient in their care provides the patient with a sense of contribution rather...
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Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
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Choosing Wisely For Critical Care: The Next Five.

Jerry J Zimmerman1, Lori A Harmon2, Pamela L Smithburger3

  • 1Department of Pediatrics, Seattle Children's Hospital, Harborview Medical Center, University of Washington School of Medicine, Seattle, WA.

Critical Care Medicine
|February 8, 2021
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Summary

New critical care guidelines focus on reducing waste. Five key recommendations for "Choosing Wisely" in critical care include optimizing invasive devices, liberating patients from mechanical ventilation, antibiotic stewardship, early mobilization, and goal-concordant care.

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Area of Science:

  • Critical Care Medicine
  • Health Services Research
  • Medical Economics

Background:

  • The "Choosing Wisely" campaign aims to reduce healthcare waste.
  • Critical care is a high-cost area with potential for practice pattern improvement.
  • Previous recommendations exist, necessitating updated guidance.

Purpose of the Study:

  • To develop new "Choosing Wisely" recommendations for critical care.
  • To identify best practices that minimize waste and maximize value in critical care.
  • To align critical care practices with evidence-based, cost-effective strategies.

Main Methods:

  • Semistructured narrative literature review.
  • Quantitative survey assessments of critical care practices.
  • Modified Delphi consensus building and taskforce assessment.

Main Results:

  • Eight novel recommendations to avoid wasteful critical care practices were identified.
  • A Society of Critical Care Medicine membership survey ranked these recommendations.
  • Five highest-ranked recommendations were established as the "Next Five" "Choosing Wisely" practices.

Conclusions:

  • Five new recommendations target invasive devices, mechanical ventilation liberation, antibiotic stewardship, early mobilization, and goal-concordant care.
  • These recommendations aim to reduce waste and enhance value in critical care.
  • The updated guidelines supplement existing "Choosing Wisely" critical care initiatives.