Constant observation is defined as “an increased level of observation and supervision which continuous one-to-one monitoring techniques are utilized to assure the safety and wellbeing of an individual patient in the patient care environment. In the hospital setting constant observation has become the most used resource for mental health patients. The use of constant observation has significantly improved patient safety outcomes reducing falls and suicide rates drastically. With one study in Pennsylvania showing a vast improvement in patient safety in simply one-month times. As fall rates decreased from 53,966 falls occurring without the implementation of constant observation to only 323 falls occurring with the implementation of constant observation (Feil & Wallace, 2014). Another study completed in England over a four-year period revealed the impact that constant observation had on decreased self-harm and suicide rates within the hospital setting. With self-harm/suicide rates decreasing from 236 without the implementation of constant observation to a mere 17 with the implementation of constant observation (Janofsky, 2009). Over the years constant observation has proven that it is a remarkable safety intervention and has become the backbone of safe practice for mental health patients reducing the use of physical and chemical restraints.

Despite all the positive reviews from constant observation concerning safety outcomes, there is a disproportionate amount of information about how constant observation affects the patients it is implemented it. There is also an absence of actual therapeutic implementation for this intervention for mental health patients. This is disheartening as this is an intervention commonly used for this patient population and has been named by The Joint Commissions in 2009 as “the primary intervention for mental health patients in the hospital setting” (Sinvani et al., 2019).

Date of publication

Fall 12-5-2022

Document Type

MSN Capstone Project



Persistent identifier



Family Nurse Practitioner

Included in

Nursing Commons