(149) Piloting a Standardized Documentation Protocol for Observational Sitters on Non-Psychiatric Units

Abstract:

Background: Documentation is a tool for communication within a healthcare team that can better enable continuity of care between team members and improve care (Brooks, 2021). One-to-one observation sitters are often utilized in delirious or behavioral crisis patients (Harding, 2010) and may be a valuable source of clinical information. However, because there is no standardized job description or training for such sitters (Carr, 2013), formal standardized documentation is lacking and much information is lost. The goal of our study is to pilot a standardized documentation template for sitters observing patients on non-psychiatric units to evaluate feasibility. Additionally, we hypothesize that provider satisfaction regarding available data for medical decision-making will increase.

Methods: Data will be collected at a private academic medical center. A pre-intervention survey assessing for satisfaction with available patient data and time spent information-gathering was distributed to medical students, residents, fellows, and attending physicians that worked on the inpatient consultation-liaison (CL) psychiatry service from June 2019-February 2022. In March 2022, an intervention was implemented in which a paper questionnaire consisting of multiple choice and written answers was given to all sitters of patients being seen by the CL psychiatry team and collected the next morning by a CL psychiatry team member to be used as an information source to assist the team with their daily medical decision-making. Post-intervention surveys will then be sent to medical students, residents, fellows, and attendings who were present for at least 1 month of this intervention. This intervention will continue for a minimum of 3 months.

Results/Discussion: This study has been IRB approved and data is currently being collected.



Implications: Observation sitters represent an underutilized source of behavioral information for CL psychiatrists with the potential to impact medical decision making and ultimately patient outcomes. This study will provide practical information on the perceived utility and satisfaction of standardized sitter observations relative to feasibility, and thus inform future efforts in the development of standardized education and training protocols for observation sitters.



References:

1. Brooks N. How to undertake effective record-keeping and documentation. Nurs Stand. 2021;36(4):31-33.
2. Harding AD. Observation assistants: sitter effectiveness and industry measures. Nurs Econ. 2010;28(5):330-336.

3. Carr FM. The role of sitters in delirium: an update. Can Geriatr J. 2013;16(1):22-36.