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What Decision-Making Processes Are Used by Nurses in Initiating, Monitoring, and Ending One-to-One Observations? A
Joel Stanton1, Carol Stiles, Paula Anderson
1Author Affiliations : Nursing & Midwifery Workforce Team, University College London Hospitals NHS Foundation Trust, London, United Kingdom (Mr Stanton); University College London Hospitals NHS Foundation Trust, London, United Kingdom (Mss Stiles, Anderson, Prof Taylor); Department of Targeted Intervention, University College London (UCL), London, United Kingdom (Prof Vindrola-Padros); and Centre for Nurse, Midwife and AHP Research, University College London Hospitals NHS Foundation Trust, London, United Kingdom (Dr Ivany).
Background:
There is a lack of evidence-based processes to support nurses in appropriately utilizing one-to-one observations for patients at risk of avoidable harm in acute hospitals.
Purpose:
The purpose of this systematic review was to identify the decision-making processes surrounding one-to-one observations.
Methods:
Five databases were searched in July 2020 and July 2024. Papers were included if they discussed decision-making processes for one-to-one observations for acute adult inpatients. Data were extracted to a review database and analyzed thematically.
Results:
Sixteen publications were included. The decision-making tools described were assessment tools, local processes, and clinical judgement. The most common tool was an institutional decision-making process, which often was a combination of clinical assessment and clinical action guidance.
Conclusion:
Various tools and processes are used to facilitate decision-making on the use of one-to-one observations but few of the tools are evidence-based.
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