BACKGROUND There are few evidence-informed guidelines and findings to show that the use of sitters improves patient safety; overall, it is a costly intervention to address patients with disruptive behaviors. OBJECTIVE The purpose of this article is to demonstrate that the creation of a multidisciplinary consultation-liaison (C-L) team, integrated with a psychiatric C-L team, together can decrease sitter use and improve outcomes using nonpharmacologic interventions. METHODS This retrospective study describes the planning, implementation, and data collection using in creating an multidisciplinary C-L team to collaborate with the psychiatric C-L team and outcomes to support the approach. The multidisciplinary C-L team was composed of advanced practice registered nurses and creative art therapists. The teams worked closely with the medical units to develop and monitor criteria for sitter use. The key outcomes of the intervention improved patient safety and reduced overall cost. RESULTS In the first year of implementation of a multidisciplinary C-L approach, sitter use decreased by 72%. Nonpharmacologic interventions improved patient outcomes by providing education to medical staff that enhanced the assessment and implementation of enhanced observer use across all the medical units. Subsequent data also reflect a sustained reduction in cost over the next 2-year period, saving the institution nearly $70K a month. CONCLUSION An multidisciplinary C-L and psychiatric C-L team collaborated on the need for psychiatric medications, or nonpharmacologic interventions to address behaviors and decrease the need for an enhanced observer. The teams worked together to make policy revisions and algorithms and provide education, the result of which was significant financial savings and improved patient safety.

中文翻译：

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一种多学科协商联络小组的方法来减少观察员的使用

背景 很少有循证指南和调查结果表明使用保姆可以提高患者安全；总体而言，解决具有破坏性行为的患者是一项代价高昂的干预措施。目标本文的目的是证明多学科咨询联络 (CL) 团队的创建与精神科 CL 团队的结合，可以使用非药物干预减少保姆的使用并改善结果。方法 这项回顾性研究描述了用于创建多学科 CL 团队以与精神病学 CL 团队合作的计划、实施和数据收集以及支持该方法的结果。多学科 CL 团队由高级执业注册护士和创意艺术治疗师组成。这些团队与医疗单位密切合作，制定和监测保姆使用标准。干预的主要结果提高了患者的安全性并降低了总体成本。结果 在实施多学科 CL 方法的第一年，保姆使用率下降了 72%。非药物干预通过向医务人员提供教育来改善患者的预后，这些教育增强了所有医疗单位对增强观察员使用的评估和实施。随后的数据还反映了未来 2 年期间成本的持续降低，为该机构每月节省了近 7 万美元。结论 多学科 CL 和精神科 CL 团队合作解决了对精神科药物或非药物干预的需求，以解决行为问题并减少对增强观察者的需求。