Do not do recommendations in different paediatric care settings

An Pediatr (Engl Ed). 2023 Apr;98(4):291-300. doi: 10.1016/j.anpede.2023.02.019. Epub 2023 Mar 21.


Introduction: There are many initiatives aimed at eliminating health care interventions of limited utility in clinical practice. The Committee on Care Quality and Patient Safety of the Spanish Association of Pediatrics (AEP) has proposed the development of "DO NOT DO" recommendations (DNDRs) to establish a series of practices to be avoided in the care of paediatric patients in primary, emergency, inpatient and home-based care.

Material and methods: The project was carried out in 2 phases: a first phase in which possible DNDRs were proposed, and a second in which the final recommendations were established by consensus using the Delphi method. Recommendations were proposed and evaluated by members of the professional groups and paediatrics societies invited to participate in the project under the coordination of members of the Committee on Care Quality and Patient Safety.

Results: A total of 164 DNDRs were proposed by the Spanish Society of Neonatology, the Spanish Association of Primary Care Paediatrics, the Spanish Society of Paediatric Emergency Medicine, the Spanish Society of Internal Hospital Paediatrics and the Medicines Committee of the AEP and the Spanish Group of Paediatric Pharmacy of the Spanish Society of Hospital Pharmacy. The initial set was limited to 42 DNDRs, and the selection over successive rounds yielded a final set of 25 DNDRs, with 5 DNDRs for each paediatrics group or society.

Conclusions: This project allowed the selection and establishment by consensus of a series of recommendations to avoid unsafe, inefficient or low-value practices in different areas of paediatric care, which may contribute to improving the safety and quality of paediatric clinical practice.

Keywords: Atención de bajo valor; Choosing wisely; Eligiendo con prudencia; Low-value care; Paediatrics; Pediatría; Prevención cuaternaria; Quaternary prevention; Recomendaciones «no hacer»; «Do not do» recommendations.

MeSH terms

  • Child
  • Humans
  • Neonatology*
  • Pediatric Emergency Medicine*
  • Pediatrics*
  • Quality of Health Care