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Choosing Wisely Canada

Canadian Nurses Association

Tube feeding for older adults with advanced dementia offers no benefit over careful feeding assistance related to the outcomes of aspiration pneumonia and the extension of life. While food is the preferred form of obtaining nutrition, oral supplements may be beneficial if this intervention meets the person’s known goals of care. Tube feeding may contribute to client discomfort and result in agitation, the use of physical and/or chemical restraint and worsening pressure wounds.

Choosing Wisely Canada

Canadian Nurses Association

Adult incontinence containment products are frequently used for continent patients (especially women) with low mobility. Yet the literature associates their use with multiple adverse outcomes including diminished self-esteem and perceived quality of life, and higher incidence rates of dermatitis, pressure wounds and urinary tract infections. Among older adults, nurses should conduct a thorough assessment to determine the risk of such outcomes before initiating or continuing the use of ...

Choosing Wisely Canada

Canadian Nurses Association

Oxygen is frequently used to relieve shortness of breath. However, supplemental oxygen does not benefit patients who are short of breath but not hypoxic. Supplemental flow of air is as effective as oxygen for non-hypoxic dyspnea.

Choosing Wisely Canada

Canadian Nurses Association

Additional layers of bedding can limit the pressure-dispersing capacities of therapeutic surfaces (such as therapeutic mattresses or cushions). As a result, extra sheets and pads can contribute to skin breakdown and impede the healing of existing pressure wounds.

Choosing Wisely Canada

Canadian Nurses Association

Certain groups recommend self-monitoring of blood glucose (SMBG) to help clients with diabetes monitor glycemic control. Yet many studies show that, over time, routine SMBG does little to control blood sugar for most non-insulin-using adults with type 2 diabetes. It should be noted that SMBG would be indicated during illness or medication change, and this should be part of client assessment and education.