Constant observation practices in the general hospital setting - A national survey

The authors conducted a national survey of 355 general medical/surgical hos pitals to assess constant observation (CO) practices. The authors assessed overall use, expense, staffing patterns, funding strategies, and cost-savin g interventions. Virtually all responding hospitals (N=102) reported using some form of CO. Several hospitals reported significant decreases in CO exp enditures after the implementation of cost-saving interventions (the larges t annual decrease reported was $340,000). Cost-saving interventions include d utilizing consolidated bed spaces, relocating patients near nursing stati ons, placing at-risk patients in bed enclosure devices, and regularly assis ting patients to the toilet. In addition, less costly personnel were hip-ed , and volunteers and/or patient family members provided CO (or were require d to assist with the cost of CO). Finally, hospital staff were educated abo ut the costs and the appropriate use of CO. They were also taught to recogn ize and effectively treat delirium.