Constant observation of pediatric patients at risk for self-harm and suicide: An evidence-based practice inquiry

Area of Science:

• Pediatric behavioral health
• Suicide prevention strategies
• Patient safety

Background:

• Suicide is a leading cause of death in US pediatric patients.
• Constant observation is a recommended strategy for suicide prevention in hospitalized behavioral health patients.
• Constant observation involves continuous one-to-one monitoring for patient safety.

Purpose of the Study:

• To search for the best evidence on constant observation practices for pediatric patients at risk of self-harm or suicide.
• To identify challenges associated with implementing constant observation in pediatric behavioral health settings.

Main Methods:

• Evidence-based practice inquiry.
• Literature search for best evidence on constant observation.
• Analysis of literary themes related to constant observation challenges.

Main Results:

• No high-level evidence was found regarding constant observation practices for pediatric patients.
• Four literary themes emerged: confusing language/definitions, untested models of care, privacy issues, and lack of pediatric-specific strategies.
• Impaired communication was a common factor across all identified themes.

Conclusions:

• Current evidence on constant observation for at-risk pediatric patients is limited.
• Significant challenges exist in the implementation and effectiveness of constant observation.
• Addressing communication and standardizing definitions are crucial for improving pediatric suicide prevention strategies.