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Critical Care Medicine • Volume 46 • Number 1 (Supplement) www.ccmjournal.org Learning Objectives: The Choosing Wisely® campaign aims to promote the effective use of health care resources. The Critical Care Societies Collaborative identified five tests and treatments that were overused, including the use of parenteral nutrition (PN) within the first seven days of intensive care unit (ICU) stay in adequately nourished patients. PN in this circumstance is associated with harm, or at best no benefit, in addition to unnecessary costs. Nutrition support teams (NSTs) decrease complications and costs associated with PN; however, little is known about their impact on the timing of PN use in critically ill patients. We sought to assess if our institution’s NST was effective at meeting the Choosing Wisely® campaign’s recommendations for PN. Methods: We conducted a retrospective cohort study of all patients admitted to our institution’s ICUs who received an NST consult for PN from October 1, 2014 through July 31, 2016. Outcome measures included: proportion of patients receiving PN during the first 7 days of ICU stay, acceptance of NST recommendations for PN timing by the primary treating service, and proportion of PN prescribed by the NST. Results: Thirty consults to the NST were received during the study timeframe. In total, twenty patients (67%) received PN. Four patients (13%) received PN during the first week of ICU stay. Of the patients who received PN during the first week of ICU stay, three patients had moderate malnutrition severity diagnosis and one patient had severe malnutrition severity diagnosis. Of the ten patients that did not receive PN as recommended by the NST, seven patients received exclusively enteral nutrition and three patients had goals of care that excluded the use of PN. In those patients in which PN was deferred, no patients required initiation of PN after seven days of ICU stay. Overall, 27 of 30 patients (90%) had recommendations made by the NST regarding timing and route of specialized nutrition support that were accepted by the primary treating service. All patients (100%) had PN prescribed by the NST. Conclusions: In our institution, an NST appeared to be an effective method at meeting the Choosing Wisely® campaign’s evidencebased recommendations for limiting early PN use in the ICU. Recommendations made by the NST regarding the timing and route of specialized nutrition support were mostly accepted.