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Choosing Wisely ® : Things we do for no reason

Herzke C., et al.

Fever, defined as a rectal temperature of ≥38°C (100.4°F), is a common reason for hospital admission of infants aged ≤ 90 days. Febrile infants are often admitted to the hospital due to risk for serious bacterial infections, such as urinary tract infection, bacteremia, and meningitis. The traditional observation time is 48 hours following the collection of blood, urine, and cerebrospinal fluid cultures. In the majority of these infants, bacterial infection is not the source of fever. When ...

Choosing Wisely ® : Things we do for no reason

Hall A., et al.

Hypotonic intravenous (IV) fluids have historically been the maintenance IV fluid of choice for hospitalized children. Iatrogenic hyponatremia is a common phenomenon among hos- pitalized patients and hypotonic IV fluids significantly increase the risk for hyponatremia. Although infrequent, hyponatremic encephalopathy can have catastrophic complications, making the avoidance of iatrogenic hyponatremia a priority in the hospital. Multiple studies have demonstrated that compared with hypotonic IV ...

Choosing Wisely ® : Things we do for no reason

Caulfield C., Stephens J

Chest pain is one of the most common complaints among patients presenting to the emergency de- partment. Moreover, at least 30% of patients who present with chest pain are admitted for observa- tion, and >70% of those admitted with chest pain undergo car- diac stress testing (CST) during hospitalization. Several clinical risk prediction models have validated evaluation processes for managing patients with chest pain, helping to identify those at a low risk of major adverse cardiac events. Among ...

Choosing Wisely Australia

Pharmaceutical Society of Australia

The use of benzodiazepines, other sedative hypnotics or antipsychotics in older adults for insomnia, agitation or delirium is associated with a range of adverse effects including falls and impaired cognition. Non-pharmacological interventions can be an effective substitute and use of these medicines should be for the shortest duration possible. Reductions in the use of these medicines can be achieved following pharmacist review, interdisciplinary input, staff education and feedback from audits.

Choosing Wisely Australia

Pharmaceutical Society of Australia

The use of medications for older people can improve symptom control and reduce disease progression. However, the use of five or more medications is independently associated with poor clinical outcomes including increased hospital admissions, falls and premature mortality. Deprescribing (which is the process of discontinuing or reducing medications) is an intervention to improve the quality use of medicines. Deprescribing is an intervention to manage polypharmacy that requires balancing the ...