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Close Observation Unit to Prevent Falls and Minimize Use of Patient Care Companions

Skowronsky, Catherine MSN, ACNS-BC, CMSRN; Bena, James F. MS; Albert, Nancy M. PhD, CCNS, NE-BC

doi: 10.1097/NCQ.0000000000000072

Fall rates and patient companion use were examined after opening a close observation unit (COU) for patients with internal medicine diagnoses. Of 2023 patients (COU, n = 145; internal medicine unit, n = 1878), COU patients had more neurologic and psychiatric problems, had a longer mean length of stay, and were discharged home less often than internal medicine unit patients. Although COU patients had higher acuity, there were no differences between groups in fall rates per 100 patient-days and no use of patient companions in the COU.

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Department of Nursing Education and Professional Development (Ms Skowronsky), Quantitative Health Sciences (Mr Bena), and Nursing Institute–Office of Nursing Research and Innovation (Dr Albert), Cleveland Clinic, Cleveland, Ohio.

Correspondence: Catherine Skowronsky, MSN, ACNS-BC, CMSRN, Department of Nursing Education and Professional Development, Cleveland Clinic, 9500 Euclid Ave. H80-57, Cleveland, OH 44195 (

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: May 12, 2014

Published ahead of print: June 17, 2014

© 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins