Stanton, Joel; Stiles, Carol; Anderson, Paula; Taylor, Rachel M; Vindrola-padros, Cecilia; Ivany, Elena; (2026) What Decision-Making Processes Are Used by Nurses in Initiating, Monitoring, and Ending One-to-One Observations? A Systematic Review. Journal of Nursing Care Quality , 41 (1) pp. 42-48. 10.1097/NCQ.0000000000000878.

Text Vindrola_Decision making review_Accepted Manuscript.pdf - Accepted Version Access restricted to UCL open access staff until 11 May 2026. Download (150kB)

Abstract

BACKGROUND: There is a lack of evidence-based processes to support nurses in appropriately utilizing one-to-one observations for patients at risk of avoidable harm in acute hospitals. PURPOSE: The purpose of this systematic review was to identify the decision-making processes surrounding one-to-one observations. METHODS: Five databases were searched in July 2020 and July 2024. Papers were included if they discussed decision-making processes for one-to-one observations for acute adult inpatients. Data were extracted to a review database and analyzed thematically. RESULTS: Sixteen publications were included. The decision-making tools described were assessment tools, local processes, and clinical judgement. The most common tool was an institutional decision-making process, which often was a combination of clinical assessment and clinical action guidance. CONCLUSION: Various tools and processes are used to facilitate decision-making on the use of one-to-one observations but few of the tools are evidence-based.

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