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Alternative Strategies to Constant Patient Observation and Sitters: A Proactive Approach

Laws, Denise DNP(c), MSN, RN; Crawford, Cecelia L. DNP, RN

Journal of Nursing Administration: October 2013 - Volume 43 - Issue 10 - p 497–501
doi: 10.1097/NNA.0b013e3182a3e83e
Departments: Spotlight on Staffing

The evidence is inconclusive as to whether better patient outcomes for behavioral issues in acute care are achieved using constant patient observation. Nurse leaders at a northern California hospital designed and implemented proactive strategies to identify patients at risk for behavioral issues, developed evidence-based interventions to reduce the use of sitters and constant observation, and maintained or improved patient safety.

Author Affiliations: Director for Clinical Education, Practice, and Informatics for the Marin/Sonoma Service Area (Ms Laws), Kaiser Permanente Hospital, Santa Rosa, California; Project Manager (Dr Crawford), Southern California Kaiser Permanente Regional Nursing Research Program, Pasadena, California.

The literature review for this article is sourced from 2 integrative reviews conducted by Dr Crawford for the Kaiser Permanente Southern California Regional Nursing Research Program, as sponsored by KP SCAL Regional Patient Care Services. The integrative reviews for “Prevention and Management of Delirium” and “Use of Hospital Sitters” can be found at

The authors declare no conflicts of interest.

Correspondence: Denise Laws, DNP(c), MSN, RN, Kaiser Permanente Hospital, Santa Rosa, California, 401 Bicentennial Way, Santa Rosa, CA 95403 (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins