UT-Harris County Psychiatric Center
Nursing Procedures
Nursing
Harris County Psychiatric Center: Office Administration
Patients who need close observation but do not require 1:1 supervision, may be placed on direct observation to ensure a safe milieu for all
direct observation, precautions checklist
The University of Texas Health Science Center at Houston
Date of
LastReview: 4/07
Patients who need close observation but do not require
1:1 supervision, may be placed on direct observation to ensure a safe milieu
for all.
Procedure:
A patient on direct observation, must be assigned to a
specific staff member as designated on the assignment sheet.
The patient must remain within eyesight of the assigned
staff member at all times including bathing, showering, shaving, toileting and
while on off-unit activities. A
physician's order is not required for off-unit activities.
An order for direct observation is entered by the
physician, or a registered nurse as an independent nursing intervention until a
physician's order is obtained.
A physician's order must be obtained within 24 hours of
the nursing order.
The registered nurse is to communicate the patient's
status to all members of the treatment team.
The treatment team assesses the patient every 24 hours to ensure that
direct observation is necessary and reordered every 24 hours as needed.
The patient is monitored and documentation recorded on
the Precautions
Checklist every 15 minutes, 24 hours per day. The RN will document each shift assessment using the Nursing
Flow Sheet/Progress Notes.
Related Standards: