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March 5, 1982

Procedures of Unproved Value

JAMA. 1982;247(9):1278-1279. doi:10.1001/jama.1982.03320340036028

Medical history is full of instances where previously accepted therapies and investigative practices have been rightly discarded after their ineffectiveness has been demonstrated. Regrettably, a few procedures of unproved value still linger in many hospitals. Paramount among these are the time-honored and time-consuming routine nursing procedures of counting respiration rates on all patients twice daily, and preoperative administration of enemas whether or not large-bowel surgery is contemplated. The recommended abolition of the former procedure does not of course belittle its value when specifically required and accurately performed.

These procedures have been or are in the process of being abandoned in most other economically developed countries. In light of experience in East Africa, the author made a largely unheeded plea for their abandonment to both the medical1 and nursing2 professions more than 15 years ago.

Routine Twice-Daily Respiration Counts  At a time when a nurse's observations were almost limited to