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

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

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

Patient Safety Attendants (PSA)

Patient Safety Attendants (PSA) - Clinical Hub, Patient Safety, Nursing Quality and Safety Resources, Constant Observation

Focus

If a patient meets criteria for Constant Observation, and meets exclusion criteria for a video monitoring, a Patient Safety Attendant will be provided as available.

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
  • Skin sleeves
  • Low bed with enhanced alarm
  • Closer to the nursing station
  • Pain assessment/management
  • Medication management
  • Toileting program
  • Sleep assessment
  • Orientation
  • Assess for delirium & implement appropriate interventions
  • Intentional rounding
  • Consider non-pharmacologic treatments for sleep, pain, and/or anxiety

FAQ

When should a patient with “Suicide Precautions” have a PSA?

For inpatients who have a “yes” statement to any of the suicide screening questions or if the patients words or behaviors imply risk of suicide, the treating physician is notified to determine if any further interventions or assessments are necessary. The treating physician may place the Suicide Precautions Order which includes a choice for a PSA. If the physician determines further assessment is needed, Department of Psychiatry Consult service is available 24/7 for full suicide assessments.

What are some techniques to redirect and communicate with an agitated patient?

What modifications can be made to the environment to help agitated patients?

How can the PSA help limit sensory input for agitated patients?

Resources

Suicide Assessment and Prevention

Unit Operations

Related

Ace Team

Delirium Nursing Practice Guideline

Falls Nursing Practice Guideline

Geriatric Resource Nurse

Pain Management Resources

Psychosocial Issues/Psychiatric Liaison