If you were to sit at our family dinner table in the evenings, you would quickly realize I find joy in celebrating achievements large or small. Whether it is success on a school assignment, learning to play an instrument or a new piece of music, or getting a promotion at work, I believe that all successes are worthy of recognition.
This is why it was so personally and professionally satisfying recently to share with my AvaSure colleagues a milestone in our Online Reporting of Nursing Analytics (ORNA®) program. For those who may not know it, ORNA® is a key differentiator in the services we offer our customers. It is the only comparative performance database in remote patient safety monitoring. Its data has been used in a number of clinical studies by customers to showcase results and by many more to improve their AvaSure program.
So I donned a party hat and blew a party whistle to commemorate the occasion – the 1 millionth patient discharged from ORNA®, an event that occurred on Feb. 24. To put this into context for my visual friends, if those patients were lying head-to-toe in their hospital beds, they would stretch from Belmont, Mich., AvaSure’s headquarters, to the University of New Mexico Hospital in Albuquerque (and a customer!).
Those 1 million patients represent nearly 70 million monitoring hours in the ORNA® database. During those hours, more than 7 million adverse events were prevented. With the use of the TeleSitting technology, patients have been saved from the harm of a fall or eloping from their room. Medical devices stayed put instead of being yanked out by a confused patient and having to be reinserted by staff. Another thing to feel good about is knowing clinical staff were saved from much verbal and physical harm.
Of course, in the past two years, we documented thousands of COVID patients being watched around the clock by staff who did not have to don PPE and risk exposure to the coronavirus on many occasions, or knew the instant a patient needed an intervention.
ORNA® provides a data community for our customers. AvaSure program managers have the ability to review their metrics and celebrate milestones whether it be percent of room units in use, reaching a safe Stat alarm response time average at the hospital or care unit level or comparing their hospital to peers to see where they are ahead of the curve and what needs improving.
ORNA® allows program managers to export graphs and share them hospital-wide with key stakeholders within the program. These results are often part of executive-level dashboards as key performance indicators. This is how we improve safety and quality over time.
For more information about ORNA® and how you may be able to better utilize data within your TeleSitting program, please reach out to ORNA@avasure.com. And we encourage you to celebrate success every chance you get.
Jill Kaminski is AvaSure’s Clinical Data and Systems Analyst
There is a wealth of peer-reviewed research on AvaSure’s success in helping to reduce falls and sitter costs. Many hospitals that adopt the solution quickly see the financial and clinical payoffs, and look to expand the program. A lot of decisions need to be made, including how many rooms and/or units to cover, the challenges that need addressing, what hardware to employ and whether or not to have a single central monitoring hub or unit-based staff.
A new article in the Journal of Nursing Care Quality, centered on the experiences of Oregon Health & Science University (OHSU), explores the factors that can help clinical leaders make those choices more effectively.
After implementing AvaSure in 2018 with 10 mobile devices and three in-ceiling devices, OHSU was able to stabilize upward trends in sitter use in adult acute care. It quickly became clear that demand at OHSU would outstrip supply. A growing video monitoring waitlist and sitter utilization needs combined with staff shortages to create an urgency to getting certified nursing assistants off of sitter duty and back out on the unit, using AvaSure for every patient who met inclusion criteria.
The authors calculated that continuous virtual monitoring saved $2 million per year just on sitters. An average of 5,593 adverse events were prevented at OHSU per 1,000 patient-days in the past year.
OHSU used a variety of metrics to evaluate AvaSure program expansion, including high video monitoring utilization rates, sitter use demands, wait-list growth and national/local increases in behavioral health needs. “One of our most powerful metrics, however, is the subjective data related to staff perception of need,” the authors write. Acting on the need for expansion from a staff nurse perspective is an “imperative aspect of multilevel empowerment” at OHSU, a Magnet nursing organization.
The team success in writing an expansion initiative using those metrics added 13 mobile devices. A partner community hospital decided to leverage an opportunity to expand AvaSure into its facility for a total of 23 more room devices. As part of the expansion, OHSU is implementing a hub and spoke model with its partner.
Providers are under stress. Kaufman Hall reports that through February, the average hospital operating margin had fallen 42.4% in the first two years of the pandemic, to a negative 3.5%. Widespread staff shortages – mainly but not exclusively nurses – and pandemic-related supply chain challenges drove expenses up 32% in the same two years. There are 3% fewer staff on hand, but those who remain cost far more.
Last September, the CDC reported that because of these stresses, adverse events were on the rise. Infections, central-line and catheter-associated, as well as MRSA, increased exponentially. COVID made close observation of patients harder and delayed responses as RNs and techs needed to don PPE before entering the room. This is why more than 400 hospitals took us up on our offer of free software licenses for using AvaSure’s TeleSitter® solution to monitor COVID patients.
Social isolation and other stressors from the pandemic have also led to an explosion of behavioral health problems, including drug overdoses, suicidality, eating disorders and violence against caregivers.
AvaSure’s latest software release (Version 1.1.12.X) provides significant new features that improve communication of adverse events and allow key stakeholders to determine which events should be included in ORNA® data and reporting.
Details of suspected adverse events can be reported by monitor staff via the AvaSure TeleSitter® software, which generates emails to assigned administrators, who review the reports to determine whether events jeopardized the safety of patients/staff. Validating adverse events provides more actionable and accurate data for ORNA reports, which lead to improved processes to avert future such events.
Hospital IT is needed to configure the outgoing email server’s Notifications settings. Designated event validator(s) need to be added to the export user group through the AvaSure administrator panel. AvaSure recommends assigning this role to a minimum of two users, which allows more efficient validation in the case of time off or a user changing roles in the organization.
You must also define the adverse events you would like to track and establish them in the notifications setting. By default, assisted and unassisted falls are selected; however, a range of other adverse events can be added.
For more information on this software feature, contact info@avasure.com.
2-Way TeleSitter®
With the advent of two-way video on our 2-way Guardian® devices, AvaSure has been used for a variety of telehealth purposes. Now, new capabilities in our latest software allow monitoring staff and frontline staff to establish instant video communication. Use of this functionality has a number of implications for care delivery:
By being able to see the monitor staff, nurses are reminded that another set of eyes is always on their patient, which increases staff buy-in for remote safety monitoring, driving up utilization.
Family members are encouraged seeing there is a real person on the other end of the room unit and can take time off from caring for their loved ones.
This system helps traumatic brain injury patients who might be disturbed by voice with no video.
Two-way video access for monitor staff is determined by clinical leadership and set in AvaSure Administrator Panel®. Depending on the settings selected in AvaSure Administrator Panel, monitor staff may have the option to toggle two-way video on and off. To find out more about the 2-way TeleSitter® feature or the Guardian® 2-way mobile device contact your AvaSure sales representative or click here.
Memorial Hermann Health System leverages “virtual nurses” to help with staffing
Acting in just a couple of weeks, it shifted a cadre of critical care nurses from the bedside and placed them in a new central facility to keep close watch on high-acuity COVID patients via video and remote physiologic monitoring tools. These “virtual nurses” can care for COVID-19 patients across the system, supporting less experienced bedside nurses and improving patient quality and safety.
In an on-demand webinar hosted by Becker’s Hospital Review, a team from Memorial Hermann and AvaSure’s Chief Clinical Innovation Officer Lisbeth Votruba, describe the basics of virtual care, including the technology and the art of video and audio interactions with patients and bedside staff; the policies and workflows Memorial Hermann established for virtual nursing; and how virtual nurses can make the highest use of specialized care resources.
John O’Leary, author and activist, kicked off the day with a moving and motivational talk about thriving in the face of adversity. After 20 months of COVID-19, O’Leary encouraged attendees that the best of the journey to better healthcare is to come.
Throughout his keynote, O’Leary prompted attendees to remind their colleagues at all levels that their work matters. At an early age, O’Leary was burned on 100% of his body in an accident, and he spent much of his childhood in the hospital. Throughout his time there, his doctors empowered everyone from custodians to nurses to be a part of his journey.
Today, O’Leary is grateful for the opportunity to speak to the public at events like the AvaSure Symposium. He thanked the hardworking frontline workers, administrators and staff for all that they do, and reminded everyone that gratitude can create the largest impact, reduce stress and help find joy.
Lunch Time Knowledge Bites
After the keynote presentation, attendees had the choice of two Lunch Time Knowledge Bites sessions:
Common Challenges & Misconceptions
Working with Organized Labor & Your TeleSitter® Program
This wide range of topics was perfect for any organization that wants to take a deep dive into their AvaSure TeleSitter® solution and equip staff with what they need to thrive.
Common Challenges & Misconceptions provided both new and existing AvaSure users with insights into how to optimize among both monitor staff and program leaders. Presenter Wendy Popma-Breen, BSN, BS, RN, Clinical Implementation Services Manager at AvaSure, said that transparency and the sharing of information needs to be a key consideration for hospitals and healthcare systems. In many situations, monitor staff are not aware of the conditions or history of the patients they are monitoring. In order to keep patients safe, monitor staff need to be equipped with as much information as possible. Processes can help alleviate this strain, as well as robust onboarding and continuous learning for all staff.
After lunch, attendees attended the Keeping Suicidal Patients Safe, Virtually, presented by UC Davis and Benefis Health. Amid the ongoing mental health crisis, healthcare systems are seeing an influx of patients who are struggling with suicidal ideation, especially among adolescents.
Both teams worked closely with AvaSure to implement TeleSitter solutions that can monitor patients and mitigate risk. One of the biggest benefits of the program is the ability for monitor staff to observe patients 24/7, whereas nurses may not see signs of escalation unless they are in the room. In some case uses, the one-on-one option for the TeleSitter provided an opportunity to form a connection with patients who are in crisis, helping them on the road to recovery.
With no end to the crisis in sight, AvaSure continues its commitment to providing tools and resources to help healthcare systems best serve their patients.
Breakout Sessions
The afternoon breakout sessions included:
Tales from the Front: Early Wins Beget Long-term Success
Fostering New Use Cases for Virtual Care
Standing Up to the Surge: Virtual Nurses Help a Health System Manage COVID
In the face of the COVID-19 pandemic, staffing shortages and a deep freeze that wreaked havoc on much of Texas, Memorial Hermann Health System and its implementation of the TeleSitter program are a case study that all telehealth professionals need to hear.
In July 2020, Memorial Hermann went from initial contact with AvaSure to fully operational coverage of COVID-19 patients in 15 days. Today, Memorial Hermann has over 100 cameras across 12 care facilities in the Houston metro area. The program even allows monitor staff to work from home, when necessary. Their IT team put together workstation kits that included everything an employee would need to work from home alongside their on-site colleagues. When much of the area was hit by an ice storm earlier this year, Memorial Hermann was able to scale its program to continue to provide patients with the safety and monitoring that they needed.
The Memorial Hermann team shared many of the lessons that they learned along the way. For them, staff buy-in was essential, and they made sure that nurses knew that the program was not a critique of their work, but instead, a resource designed to support them. Additional key takeaways included the value of communication, identifying areas of concern, creating an escalation process and developing a pipeline for staffing support.
Panel 2 – Case Closed: Remote Video Monitoring Increases Staff Safety
The final panel of the AvaSure Symposium covered workplace violence. Christina Case, MSN, RN-BC, Clinical Nurse Manager at Providence St. Peter Hospital, presented alongside Lisbeth Votruba, MSN, RN, Chief Clinical Innovation Officer at AvaSure. The duo shared peer-reviewed research, ORNA data and anecdotal evidence on workplace violence and how AvaSure solutions can help prevent it. In fact, ORNA data shows that 17,077 abusive events were prevented at 195 hospitals from July 2017 to July 2021.
Once the TeleSitter was implemented at Providence St. Peter, Case and her team found success in the creation of an educational toolkit. These toolkits improved her staff’s feeling of the program, increased reporting and encouraged engagement. When asked if staff safety was more important than patient safety, Votruba and Case shared that while patient safety is extremely important, it cannot come at the cost of staff safety.
AvaSure sends a sincere thank you to all keynote speakers, moderators, panelists and participants who made the fourth annual AvaSure Symposium a success. Registered attendees will receive a link to the recordings for keynotes, panels and sessions next week.
AvaSure’s fourth annual National Symposium has closed its virtual doors following an inspiring and informative Day 2 on October 7th. Once again, the theme of connection and the growing role of telehealth took center stage as keynote speakers, panelists and presenters shared their insights.
Keynote – John O’Leary
John O’Leary, author and activist, kicked off the day with a moving and motivational talk about thriving in the face of adversity. After 20 months of COVID-19, O’Leary encouraged attendees that the best of the journey to better healthcare is to come.
Throughout his keynote, O’Leary prompted attendees to remind their colleagues at all levels that their work matters. At an early age, O’Leary was burned on 100% of his body in an accident, and he spent much of his childhood in the hospital. Throughout his time there, his doctors empowered everyone from custodians to nurses to be a part of his journey.
Today, O’Leary is grateful for the opportunity to speak to the public at events like the AvaSure Symposium. He thanked the hardworking frontline workers, administrators and staff for all that they do, and reminded everyone that gratitude can create the largest impact, reduce stress and help find joy.
Lunch Time Knowledge Bites
After the keynote presentation, attendees had the choice of two Lunch Time Knowledge Bites sessions:
Common Challenges & Misconceptions
Working with Organized Labor & Your TeleSitter® Program
This wide range of topics was perfect for any organization that wants to take a deep dive into their AvaSure TeleSitter® solution and equip staff with what they need to thrive.
Common Challenges & Misconceptions provided both new and existing AvaSure users with insights into how to optimize among both monitor staff and program leaders. Presenter Wendy Popma-Breen, BSN, BS, RN, Clinical Implementation Services Manager at AvaSure, said that transparency and the sharing of information needs to be a key consideration for hospitals and healthcare systems. In many situations, monitor staff are not aware of the conditions or history of the patients they are monitoring. In order to keep patients safe, monitor staff need to be equipped with as much information as possible. Processes can help alleviate this strain, as well as robust onboarding and continuous learning for all staff.
After lunch, attendees attended the Keeping Suicidal Patients Safe, Virtually, presented by UC Davis and Benefis Health. Amid the ongoing mental health crisis, healthcare systems are seeing an influx of patients who are struggling with suicidal ideation, especially among adolescents.
Both teams worked closely with AvaSure to implement TeleSitter solutions that can monitor patients and mitigate risk. One of the biggest benefits of the program is the ability for monitor staff to observe patients 24/7, whereas nurses may not see signs of escalation unless they are in the room. In some case uses, the one-on-one option for the TeleSitter provided an opportunity to form a connection with patients who are in crisis, helping them on the road to recovery.
With no end to the crisis in sight, AvaSure continues its commitment to providing tools and resources to help healthcare systems best serve their patients.
Breakout Sessions
The afternoon breakout sessions included:
Tales from the Front: Early Wins Beget Long-term Success
Fostering New Use Cases for Virtual Care
Standing Up to the Surge: Virtual Nurses Help a Health System Manage COVID
In the face of the COVID-19 pandemic, staffing shortages and a deep freeze that wreaked havoc on much of Texas, Memorial Hermann Health System and its implementation of the TeleSitter program are a case study that all telehealth professionals need to hear.
In July 2020, Memorial Hermann went from initial contact with AvaSure to fully operational coverage of COVID-19 patients in 15 days. Today, Memorial Hermann has over 100 cameras across 12 care facilities in the Houston metro area. The program even allows monitor staff to work from home, when necessary. Their IT team put together workstation kits that included everything an employee would need to work from home alongside their on-site colleagues. When much of the area was hit by an ice storm earlier this year, Memorial Hermann was able to scale its program to continue to provide patients with the safety and monitoring that they needed.
The Memorial Hermann team shared many of the lessons that they learned along the way. For them, staff buy-in was essential, and they made sure that nurses knew that the program was not a critique of their work, but instead, a resource designed to support them. Additional key takeaways included the value of communication, identifying areas of concern, creating an escalation process and developing a pipeline for staffing support.
Panel 2 – Case Closed: Remote Video Monitoring Increases Staff Safety
The final panel of the AvaSure Symposium covered workplace violence. Christina Case, MSN, RN-BC, Clinical Nurse Manager at Providence St. Peter Hospital, presented alongside Lisbeth Votruba, MSN, RN, Chief Clinical Innovation Officer at AvaSure. The duo shared peer-reviewed research, ORNA data and anecdotal evidence on workplace violence and how AvaSure solutions can help prevent it. In fact, ORNA data shows that 17,077 abusive events were prevented at 195 hospitals from July 2017 to July 2021.
Once the TeleSitter was implemented at Providence St. Peter, Case and her team found success in the creation of an educational toolkit. These toolkits improved her staff’s feeling of the program, increased reporting and encouraged engagement. When asked if staff safety was more important than patient safety, Votruba and Case shared that while patient safety is extremely important, it cannot come at the cost of staff safety.
AvaSure sends a sincere thank you to all keynote speakers, moderators, panelists and participants who made the fourth annual AvaSure Symposium a success. Registered attendees will receive a link to the recordings for keynotes, panels and sessions next week.
A recent trip to UCHealth’s Virtual Health Center in Aurora, CO, gave me and a colleague a breathtaking view of AvaSure as an indispensable part of healthcare delivery. From a central observation facility, this multi-hospital system is keeping patients safe at the bedside, validating telemetry alarms and supporting ICU teams in delivering critical care. In the early stages of COVID, its Virtual Health Center collected and disseminated the latest evidence-based treatment options to frontline staff who barely had time to sleep, much less review clinical research.
We at AvaSure have been planning for these new use cases, but to see them in full flight was inspiring for me and my colleague, Crystal Harding. We could see some of the seams in what the system was doing, but it was real, bringing home the potential of AvaSure to support critical care nurses and technicians as they seek to improve quality, make the highest use of staff resources and take some of the feelings of isolation out of isolation care.
We have names for these new services, but what we are doing is essentially extending the same proven technology that for a decade has been preventing bedside disasters such as falls to provide new layers of virtual care.
Here is some of what we saw on our trip:
The Virtual Health Center has three rooms. In one, five monitor techs were each watching a dozen med-surg patients for the “traditional” risks such as falling, eloping and pulling at lines and tubes. Staff were part of a research protocol on patient selection for remote monitoring. The room was mostly quiet while I was there, though I did witness an intervention to stop a traumatic brain injury patient from trying to go to the bathroom without staff help.
The telemetry room was quite a contrast. It was monitoring 500 patients from multiple workstations. Audible alarms were a constant. As I walked through the room, I imagined the staff hearing those alarms in their sleep.
The front room is the Virtual ICU, where three critical care nurses were using our technology, known as Verify, to watch over patients in all of this system’s hospitals. During night shifts, when physicians at the hospitals may not be as readily accessible, an intensivist physician joins the expert nurses in monitoring care. Verify uses AvaSure’s technology, but instead of a dozen patient rooms on screen, there are 38. Using a variety of physiologic monitors, the team can respond to the most at-risk patients based on bedside nurses’ concern or electronic trigger tools such as sepsis alerts and early warning scores, as well as visually rounding on the ICU patients.
Sepsis is a great example of the success of this approach. The health system has implemented a state-of-the-art sepsis care bundle. Changes in lactic acid levels, blood pressure and heart rate trigger an intervention, as sepsis treatment is so time sensitive. I was told of a novice nurse in one of the system’s smaller facilities who was not administering antibiotics in a timely manner to a patient in danger of slipping into septic shock. The patient had pulled out the IV and the new nurse had not been able to re-insert it. The virtual nurse found the resource needed to get the IV back in and antibiotics delivered quickly.
One of the nurses told me a story of how she witnessed a patient being coded for full cardiac arrest. She noticed that no one in the room was recording the medications given, so she took on the role of virtual recorder. There is an Advanced Cardiac Life Support algorithm that should be followed during a code. She was able to help make sure the team stayed on track. She told me: “I called into the room and reminded everyone, ‘It’s been two minutes since we last gave epinephrine; let’s give another dose now.’”
My colleague and I left our visit so inspired by the work this UCHealth is doing to keep patients safe. When the nurse told me this story, I had a lightbulb moment. While our TeleSitter® application helps keep patients physically safe, Verify is a wonderful tool for clinical safety.
All of this reminded me of a conference presentation I attended pre-COVID about virtual ICUs and the need for faster responses to “triggers,” or changes in physiologic conditions that are most closely tied to the danger of a life-threatening event. The presenters discussed how a bedside nurse has to open the electronic health record to receive one of these triggers, which might not happen if the nurse is occupied talking to a patient’s family or changing a dressing. With a virtual care team in place, the trigger generates an instant response.
The broader role we have envisioned for AvaSure is being actualized on the frontlines of care. We developed the tools, but nurses, doctors and monitoring staff are inspiring us by using them to improve the quality as well as the safety of care.
COVID-19 has had a devastating impact on children. Many have experienced profound social isolation as a result of lockdowns and remote learning; others have had their home lives shattered by the death or debilitating illness of a parent or abuse by a family member. Even before the pandemic, suicide was the second-leading cause of death among adolescents; from 2007 to 2017 rates of teen suicide increased by 56%. After COVID took hold, the proportion of children seeking emergency mental health services who required immediate hospitalization rose 75%.
Suffice it to say, capacity to treat this need, including by inpatient children’s hospitals and within pediatric units of acute hospitals, has been tested. Nurse leaders are seeking solutions that will help keep patients safer while improving productivity, especially by reducing reliance on one-to-one sitters.
One solution that has shown promise for this challenging population is remote patient safety monitoring. Over the past three years, more than 4,000 pediatric patients have been placed under video surveillance using AvaSure’s TeleSitter® solution. Fifty-seven percent of those patients present with low- to moderate-risk suicide ideation. The other 43% are placed on video monitoring for the prevention of elopement, falls, medical device interference and staff injury prevention.
The TeleSitter® solution includes in-room monitoring devices with high-resolution video and digital audio, an invisible and automatic infrared light for low-light viewing and a virtual privacy curtain activated by the monitor staff when a caregiver is working with the patient. Room devices are either mobile (wired or wireless) or a permanent ceiling installation. The camera has 360-degree pan, tilt, zoom capability, allowing it to see minute details such as whether a patient is hiding something to be used later as a ligature. Each device is equipped with a loud and distinctive alarm used to alert staff that a patient is not responding to redirection or needs assistance. The average response time to the alarms nationally is 15 seconds.
The room devices connect via Enterprise software with centralized monitoring located in one hospital or in “hub and spoke” arrangements, with systemwide or regional centers watching patients in multiple hospitals, each tech with 12-16 patients on a large screen at their workstation.
Helen DeVos Children’s Hospital in Grand Rapids, Michigan, had been using AvaSure for several years to reduce the use of safety attendants, also known as patient sitters. Later it was used to monitor pediatric patients considered to be risks for aggression and violence against staff and other patients.
As the need has grown, Helen DeVos Children’s has used TeleSitting to monitor suicide-risk patients. The hospital uses the Columbia Suicide Severity Rating Scale to screen patients who present as moderate risk of self-harm or harm to others.
Joint Commission regulations say that patients with low-to-moderate suicidal ideation must be placed under “demonstrably reliable monitoring,” a standard that can be met by “continuously monitored video” linked to the “provision of immediate intervention” by a qualified staff member when called for.
At Anne Arundel Medical Center in Annapolis, Maryland, the pediatric patient selection criteria are different from adults’. It uses the Joint Commission-validated, four-question Ask Suicide-Screening Questions (ASQ) tool to assess the level of risk the patient presents. If the patient is found to be low-to-moderate risk, he or she qualifies for telemonitoring. Though the hospital also monitors adult patients, staff are given specific training on handling pediatric patients.
One key factor in a hospital’s degree of success in adopting this solution is the effort expended on overcoming institutional resistance to change. With suicide ideation patients, providers are often adamant that a human sitter needs to be in the room at all times, even though the vast preponderance of clinical evidence shows inconsistent results, as many sitters have no medical knowledge or specific training. If sitters are not available, direct patient care staff, such as patient care technicians, are de facto sitters. Once nursing leaders see the benefit of keeping frontline staff at the bedside, the more patients are remotely monitored.
Helen DeVos Children’s has worked on establishing strong communication between the nursing staff and monitor staff to tailor the intervention to each patient’s need. One patient may be restricted to bed, while the next is allowed to get up and sit in a chair. If a patient starts pacing the room and/or exhibits signs of anxiety, the monitor tech will intervene.
For parents, video monitoring means there isn’t a stranger sitting in the room staring at their vulnerable child. Parents are also happy to learn that the video is not recording.
Another best practice is for the monitor staff to greet each patient and family through the audio, so they know a human being is watching over their child. They use a scripted introduction, letting the family know they are there to keep their child safe. We think of it as akin to “the face behind the camera.
Last, but not least, there are the savings. As so many other organizations have discovered, monitoring 12 at-risk patients remotely versus using one-to-one sitters naturally lowers costs. Sitters are a little-known source of spending that can cost a health system millions of dollars annually.
For example, in the first 11,000 hours of monitoring of pediatric patients, Anne Arundel saved $212,000. Along with greater savings at the hospital level, this creates resources that can be put to better use in improving patient care.
Authors:
Jamie Clendenin, BSN, RN-BC, is Supervisor, Nursing Operations, Anne Arundel Medical Center, Annapolis, Maryland
Melanie Lee, MSN, RN, CPN, is Clinical Director, Pediatric Emergency and Inpatient Unit, Anne Arundel Medical Center
Ashleigh Nurski, MSN, RN, ACCNS-P, CPN, is Clinical Nurse Specialist, Helen DeVos Children’s Hospital, Grand Rapids, Michigan
Stacey Overholt, RN, MBA is Clinical Director of Sales at AvaSure.
To share research results in three recent national studies on the use of the TeleSitter® solution, AvaSure recently hosted Telesitter: What’s New and Where it’s Heading, a webinar attended by over 500 chief nursing officers from all 50 states plus Washington, D.C., including VAs from around the country. The webinar was presented by AvaSure’s Chief Innovation Officer Lisbeth Votruba, MSN, RN, and Nurse Consultant Patricia Quigley, PhD.
Their studies on Patient Engaged Video Surveillance (PEVS) based on AvaSure’s Online Reporting Of Nursing Analytics (ORNA), the groundbreaking research is clear:
PEVS is clinically proven to foster significantly safer hospital environments for patients and caregivers In addition to considerable cost savings with the use of PEVS, perhaps the most telling outcome of the studies is the substantial improvement in safety for patients in witnessed events.
Prevent Falls In Falls Prevention, the 12-month study of 71 hospitals and 15,021 patients considered as high risk for fall by nursing staff, shows that with PEVS, falls were reduced to .38 falls/1000 patient days of surveillance.
“This is getting to zero, where falls hardly exist,” Quigley said. The study revealed that hospitals equipped with PEVS saw:
A savings of 453 annualized FTEs typically used for traditional sitting, representing over 943,000 hours
A 92 percent reduction to 38 FTEs to monitor PEVS
Improving nurse safety against violence The second study focused on violence against nursing workforce.
“While industry principles, OSHA guidelines and Joint Commission challenges to reduce sentinel events have been published in the past few years, there hasn’t been much improvement in reducing violence,” said Votruba.
This study included 300 witnessed events, 15,434 patients in 73 hospitals over a 21-month period to learn impact of PEVS on nursing workforce safety. The study found that with PEVS, for every abusive event witnessed, 25 were reported, including usually non-recorded verbal incidents.
And while most of the patients in this study were being monitored for fall prevention, and not violence, Votruba noted that these findings present an opportunity for more research on how to identify which patients might have the tendency to become violent.
Using PEVS for COVID-19 isolation patients The third study, by Quigley, Votruba and Jill Kaminski just released in MedSurg Nursing, focused on PEVS for COVID-19’s acute isolation population, monitoring 1,625 patients in 97 hospitals over a two-month (March-April 2020), and representing 98,918 hours of observation.
Key findings included:
42 witnessed adverse events experienced among 39 patients
29 of the events involved a dislodgement of lines
9 falls (one unassisted)
2 self-harm events
2 physical abuse toward nursing events
while response time was lowered due to the donning of PPE, there were more verbal interactions per day to comfort isolated patients during this surge period
These studies show that real-time surveillance at the point of care is cost-effective, improves safety and is easily adoptable by nurses. Nurses were resourceful in fast-tracking the technology in the early weeks of the COVID-19 pandemic as they were pulling from as many resources as they could at the height of the surge.
Lisbeth also shared highlights from several studies she recommends for further reading as CNOs consider the technology for their hospitals. Those studies are linked below for further reading.
AvaSure is working hard to advocate that PEVS programs be a workplace safety initiative through the American Nursing Association.
