A creative alternative for providing constant observation on an acute-brain-injury unit

A performance improvement project to explore creative alternatives to improve the efficiency of constant observation was performed on an acute-brain-injury rehabilitation unit. The goals of the project were to increase opportunities for therapeutic cognitive stimulation among patients, increase nursing satisfaction regarding efficient use of resources to deliver rehabilitative care, decrease constant-observation salary costs, and maintain fall and restraint rates within 10% of baseline. Implementing the project involved developing a new job description (rehabilitation patient companion) and creating a day room where patients receiving constant observation could go between therapies to receive therapeutic cognitive stimulation. The program benefited patients, staff and the hospital. This project illustrates how a creative alternative to constant observation proves beneficial on many levels and improves the delivery of rehabilitative care to patients with traumatic brain injury.