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Nursing

by
Canadian Nurses Association
Last updated: October 2020

  • The Canadian Nurses Association (CNA) established its Choosing Wisely Canada nursing list by convening a 12-member nursing working group (NWG) of diverse nurse experts from across Canada representing a broad range of geographical regions, practice settings and experience. The NWG began considering its potential list by reviewing existing recommendations, including items from Choosing Wisely Canada’s specialty societies and the American Academy of Nursing (AAN) Choosing Wisely® list, which had already undergone rigorous evidence reviews. In addition, members brought forward recommendations on new evidence-based items. The NWG appraised 195 items for relevance to nursing using a structured process developed for this work. Each of these (171 Choosing Wisely Canada physician-related items, 15 AAN Choosing Wisely items and nine independently submitted items) was appraised by two independent reviewers. Using a modified Delphi process for the next two rounds of revision, the group then refined and adapted 36 items until reaching consensus on a final nine-item list. A literature review was conducted to confirm the evidence for these items, and supporting nursing research was added where appropriate. Subsequently, the final list underwent extensive consultation, in which further input was obtained from nursing experts in patient safety, various members of the Canadian Network of Nursing Specialties, CNA, its jurisdictional members and patient advocates. In November 2016, the Choosing Wisely Canada nursing list was presented to CNA’s board of directors, who gave it their full endorsement and support.

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by
Canadian Nurses Association
Canadian Gerontological Nursing Association
Last updated: October 2020

  • The Canadian Nurses Association (CNA) and the Canadian Gerontological Nursing Association (CGNA) established its Choosing Wisely Canada nursing list by convening an 11-member nursing working group (NWG). The group consisted of gerontological nursing experts from across Canada, representing a broad range of geographical regions and practice settings. The NWG began considering its list by reviewing existing recommendations, including items from Choosing Wisely Canada’s specialty societies and the American Academy of Nursing (AAN) Choosing Wisely list, both of which had already undergone rigorous evidence reviews. In addition, members brought forward recommendations on new evidence-based items. The NWG appraised 260 items for their relevance to gerontological nursing using a structured process developed for this work. Each of these items (227 Choosing Wisely Canada items, 20 AAN Choosing Wisely items and 13 independently submitted items) was appraised by two independent reviewers and then validated by the group. Using a modified Delphi process for the next two rounds of revision, the group refined and adapted 17 items until it reached consensus on a final six-item list. A literature review was conducted to confirm the evidence for these items and supporting nursing research was added where appropriate. The list subsequently underwent extensive consultation, with input from nursing experts in patient safety, members of the Canadian Network of Nursing Specialties, patient advocates, CNA jurisdictional members, CNA nurses, principal nurse advisors, the Canadian Agency for Drugs and Technologies in Health (CADTH) and Choosing Wisely Canada’s internal clinician reviewers. In March of 2018, the Choosing Wisely Canada gerontological nursing list was presented to the CGNA executive and CNA board, both of whom gave it their full endorsement and support.

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Canadian Nurses Association
Infection Prevention and Control Canada
Last updated: August 2019

  • The Canadian Nurses Association (CNA) and Infection Prevention and Control (IPAC) Canada established its Choosing Wisely Canada nursing list by convening an eight-member nursing working group (NWG). The group consisted of infection prevention and control nursing experts from across Canada, representing a broad range of geographical regions and practice settings. The NWG began considering its list by reviewing existing recommendations, including items from Choosing Wisely Canada’s specialty societies and the American Academy of Nursing (AAN) Choosing Wisely list, both of which had already undergone rigorous evidence reviews. In addition, members brought forward recommendations on new evidence-based items. The NWG appraised 298 items for their relevance to nursing using a structured process developed for this work. Each of these items (217 from Choosing Wisely Canada, 15 from AAN Choosing Wisely and 66 that were independently submitted) was appraised by two independent reviewers then validated by the group. Using a modified Delphi process for the next two rounds of revision, the group refined and adapted 30 items until it reached consensus on a final seven-item list. A literature review was conducted to confirm the evidence for these items, and supporting nursing research was added where appropriate. The list subsequently underwent extensive consultation, with input from nursing experts in patient safety, members of the Canadian Network of Nursing Specialties, patient advocates, CNA jurisdictional members, CNA nurses, the Canadian Association for Drugs and Technologies in Health (CADTH) and Choosing Wisely Canada’s internal clinician reviewers. In September 2017, the Choosing Wisely Canada nursing list was presented to the IPAC Canada and CNA boards, who gave it their full endorsement and support.

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Canadian Nurses Association
Canadian Association of Critical Care Nurses
Last updated: July 2020

  • The Canadian Nurses Association (CNA) and the Canadian Association of Critical Care Nurses (CACCN) established its Choosing Wisely Canada nursing list by convening an 11-member nursing working group (NWG). The group consisted of critical care nursing experts from across Canada, representing a broad range of geographical regions and practice settings. The NWG began considering its list by reviewing existing recommendations, including items from Choosing Wisely Canada’s specialty societies and the American Academy of Nursing (AAN) Choosing Wisely list, both of which had already undergone rigorous evidence reviews. In addition, members brought forward recommendations on new evidence-based items. The NWG appraised 331 items for their relevance to critical care nursing using a structured process developed for this work. Each of these items (302 Choosing Wisely Canada items, 25 AAN Choosing Wisely items and 4 independently submitted items) was appraised by two working group members and then validated by the group. Using a modified Delphi process for the next two rounds of revision, the group refined and adapted 14 items until it reached consensus on a final six-item list. A literature review was conducted to confirm the evidence for these items, with support from the Canadian Agency of Drugs & Technologies (CADTH) and supporting nursing research was added where appropriate. The list subsequently underwent extensive consultation, with input from nursing experts in patient safety, members of the Canadian Network of Nursing Specialties, patient advocates, CNA jurisdictional members, CNA nurses, principal nurse advisors, CADTH and Choosing Wisely Canada’s internal clinician reviewers. In March of 2020, the Choosing Wisely Canada critical care nursing list was presented to the CNA Board of Directors, who gave it their full endorsement and support.

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