Wise choices in Nursing

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Similar to the international movement of Choosing Wisely and the Dutch list of 1366 wise choices for doctors, researchers of Radboudumc have now compiled a list of nursing activities which have little to no value to the patient.

When nurses would quit doing these activities this could save harm to the patient, money and time. Nurses can spend this time on things that are valuable to the patient. Such as communication and patient education to improve self management and participation. This list includes not covering of surgical wounds with dressing or not placing urinary catheters because of incontinence or pressure ulcers, and not using physical restraints in delirious or agitated patients.

Great cost savings
This so called ‘Beter-laten-lijst’ is handed out to the V&VN the Dutch Nurses Association at the 29th of June 2017.
The list was accompanied by three business cases. One of these showed that omitting to cover half of the surgical wounds in the Netherlands could save more than 2 million euros in material costs and 2.8 million euros in personnel costs. For the patient, covering surgical wounds does not to less wound infections and removal is painful.

Great harm savings

The researchers have searched 125 quality standards and guidelines for nurses. They selected recommendations that indicate that nurses could omit an activity in the daily care for their patients. Many recommendations are about the non-use of disinfectants or cleaning agents, as this does not lead to fewer infections or non-application of freedom-limiting measures such as physical restraints or medication in delirious or agitated. These measures can put patients at risk.
Further reading and links to papers, national radio, local TV and journals like SKIPR, Medisch Contact, Zorgvisie and Nursing:
http://www.iqhealthcare.nl/nl/nieuws/2017/06/wat-kan-een-verpleegkundige-beter-laten-stoppen-onnodige-zorg-bespaart-leed-en-geld/

Hester Vermeulenprofessor of Nursing Science IQ healthcare

'Beter laten' - team

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