Decreasing the costs of constant observation

Area of Science:

• Nursing
• Healthcare Management
• Patient Safety

Background:

• Constant observation (CO) is a resource-intensive patient safety measure.
• High costs associated with 1:1 constant observation present a financial challenge for hospitals.
• Alternative strategies are needed to optimize patient observation while managing costs.

Purpose of the Study:

• To evaluate the impact of a psychiatric liaison nurse (PLN) on reducing 1:1 constant observation (CO) in medical patient care areas.
• To assess the safety and cost-effectiveness of implementing a PLN model for CO reduction.
• To determine if a reduction in CO impacts patient fall rates or restraint prevalence.

Main Methods:

• A performance improvement project was implemented in a large metropolitan hospital.
• A bachelor's-prepared psychiatric liaison nurse (PLN) was employed to manage and reduce CO.
• Data on CO utilization, costs, falls, and restraint use were collected and analyzed.

Main Results:

• The project successfully reduced the costs associated with 1:1 CO by 50%.
• Significant reductions in CO were achieved without an increase in patient falls.
• No associated increase in the prevalence of patient restraint use was observed.

Conclusions:

• Psychiatric liaison nurses (PLNs) can effectively and safely reduce 1:1 constant observation (CO) in medical settings.
• Implementing a PLN model leads to substantial cost savings for hospitals.
• This approach enhances patient safety by optimizing observation practices while controlling expenditures.