/clinical/,/clinical/patient-safety/,/clinical/patient-safety/quality-safety/,/clinical/patient-safety/quality-safety/constant-observation/,

/clinical/patient-safety/quality-safety/constant-observation/

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UWHC,

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Clinical Hub,Patient Safety,Nursing Quality and Safety Resources

Constant Observation

Constant Observation - Clinical Hub, Patient Safety, Nursing Quality and Safety Resources

Constant observation is an intervention by health care personnel to ensure safe, effective care for patients. Constant observation can be an in person patient observer (Patient Safety Attendant or PSA) or a video monitoring camera.


Focus

The patient’s nurse and Care Team Leader are responsible for assessing a patient’s need for constant observation. They are responsible for overseeing UWHC Nursing Assistants (NA), outside agency, and other staff who assist with providing constant observation. The patient’s nurse and Care Team Leader are responsible for discontinuing the intervention of constant observation when the patient no longer meets criteria for constant observation.

If Constant Observation is requested, nursing staff will:

Criteria for Constant Observation Evaluation – Reference

Criteria for Constant Observation

  1. Confused AND at least one of the following:
    • Wandering/Elopement (active)
    • Pulling at critical lines/drains/airways
    • Pulling at critical brace(s)
    • Unsteady gait and high risk for injurious fall
  2. Violent and/or self-destructive restraints
  3. Locked restraints 
  4. Suicide precautions 
  5. Other

Alternatives

Attempt appropriate alternatives prior to request for Constant Observation:

  • Door alarm
  • Bed/chair alarm
  • Removing unnecessary lines
  • Hiding lines/drains
  • Low bed
  • Closer to the nursing station
  • Pain assessment/management
  • Medication management
  • Toileting program
  • Sleep assessment
  • Orientation
  • Assess for delirium and implement appropriate interventions
  • Intentional rounding

 

Flowchart for determining levels of constant observation

FAQ

How is constant observation initiated?

Do I still need an “Evaluate for Constant Observation” order for suicidal patients requiring constant observation?

What are the changes to documentation?

How do the Nursing Coordinators know that constant observation is still needed?

How will the Nursing Coordinators know that the constant observation has been stopped?

What are alternatives to constant observation?

Resources

Constant Observation (HFFY 7900)

Constant Observation (Adult and Pediatric)

Related

Ace Team

Delirium Nursing Practice Guideline

Falls Nursing Practice Guideline

Geriatric Resource Nurse

Pain Management Resources

Psychosocial Issues/Psychiatric Liaison