3095 Reduction in the use of nursing enhanced observation within acute care

Abstract NHS Forth Valley, acute services identified an increase of over 122% demand on the request for patients to receive enhanced observations during 2023–2024. In March 2024 a project was undertaken to understand the cause of the increase. This highlighted patients were not appropriately risk assessed or regularly reviewed and there was also a lack of evidence that the least restrictive options had been explored. The sample review also demonstrated patients were not engaged in meaningful activity, cognitive rehabilitation or stimulation, which therefore provided an absence of evidence of the benefit to patient, highlighted a risk of a prolonged length of stay, risk of exacerbating stress and distress and potential increase of physical harm. In addition, enhanced observation has a significant financial impact due to the requirement of supplementary staffing. Improvement interventions with education and adapting electronic systems has led an 86% reduction of patient identified as requiring enhanced obs. In addition this has seen a 94% reduction in supplementary hours used and supplementary staffing requests through the staff bank. NHS Forth Valley have seen no themes in adverse events or complaints which related to the reduction in use of enhanced observations.