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EXECUTIVE SUMMARY
* With increasing acuity and simultaneous pressures for optimal productivity, reducing unnecessary patient companions has been a focus for many health care organizations.
* At the same time, nursing leaders are seeking to accelerate improvement in patient safety, specifically the prevention of falls.
* This study suggests the use of remote video monitoring is a safe tool for fall prevention.
* While there was a decrease in 1:1 sitter usage, there was no corollary increase in falls. In fact, falls decreased 35%.
* Not only was video monitoring a safe intervention, it was more effective than patient companions alone in decreasing falls by expanding the number of patients who are directly observed 24/7.
PREVENTING PATIENT FALLS is a challenge for all health care organizations. Patient falls in the adult population carry a heavy financial burden and a significant cost in human suffering. Falls in the acute care setting cause additional morbidities, are associated with psychosocial trauma, and increase mortality risk for older adults (Tideiksaar 2010). In the hospital setting, 9%15% of falls result in injury (Tideiksaar 2010). According to the Centers for Disease Control and Prevention (CDC, 2013), the financial cost of a fall with injury in an older adult is estimated at $17,500. In response to these risks, nurses often turn to 1:1 patient companions as an intervention to prevent falls (Rochefort, Ward, Ritchie, Girard, & Tamblyn, 2012). Because of the expense of 1:1 patient companions, remote video monitoring has become an attractive option to reduce falls as it allows one telesitter to observe and verbally redirect multiple patients from a remote location.
The specific aim of this study was to evaluate the effectiveness of remote video monitoring with a dedicated telesitter in order to reduce falls, as well as to reduce patient companion usage in the inpatient adult population.
Literature Review
Patient companions are a costly fall-prevention intervention with equivocal results. Many organizations have implemented strategies to decrease patient companion usage without any significant change in fall rates (Adams & Kaplow, 2013; Laws & Crawford, 2013; Salamon & Lennon, 2003; Spiva et al., 2012). Harding (2010) reflected on the use of physical sitters to decrease falls. They were unable to provide correlation of sitter use to decreased fall rates, elopement,...