The impact of the Cognitive Impairment Support Program on constant observation practices in acute surgical settings: a pre-post study

Constant observation is commonly used to provide one to one surveillance for patients who are experiencing cognitive impairment in acute hospital settings. There is scant evidence that using constant observation reduces adverse events or improves health outcomes. Support programs for cognitively impaired patients may reduce needs for constant observation. This study examined the impact of a Cognitive Impairment Support Program on constant observation practices in an acute surgical setting.A pre-post study was conducted in two surgical wards at a metropolitan hospital. Patients aged ≥65 years (or ≥45 years for Aboriginal and Torres Strait Islander people) who underwent constant observation were included. The primary outcome measure was frequency of constant observation. The presence of one or more hospital acquired complications (delirium, urinary tract infection, pressure injury, pneumonia and falls) was a secondary outcome.There were 908 and 1203 admissions in the two study periods. The median length of stay for patients who required constant observation was significantly higher compared to patients who did not (6 vs 3 days, pThis study provides preliminary findings that the Cognitive Impairment Support Program may reduce constant observation utilisation in a surgical setting. Further prospective research is required to fully understand the impact of multi-component support programs on constant observation in patients with cognitive impairment