Challenge

Caregivers without behavioral health expertise struggle to manage behaviorally challenging patients while providing continuous observation (CO) care. During CO, one caregiver is assigned to provide complete and constant care to one patient. Serving as CO staff for patients who are at risk for aggressive and violent behaviors places hospital employees at increased risk for becoming victims of workplace violence.

Solution

Nurse leader rounding with an educational toolkit yielded CO staff-endorsed feelings of increased staff safety and engagement. The purpose of the STARS project was to trial the effectiveness of structured, in‐person nurse leader rounding with an educational toolkit to improve the feeling of CO staff safety and reduce the need for CO by engaging the patient, care team, and family in providing holistic care to patients requiring CO. Patient readiness to trial remote video monitoring CO was assessed, and violence prevention and assault reporting education to CO staff was reinforced.

The survey results revealed:

• Improved feelings of safety when in an CO assignment because of the STARS project
• Perception that the STARS project had been helpful in reducing violence
• Belief that the STARS project has brought attention to the importance of the CO role in improved health for the patient
• Belief that the STARS project has improved CO care