New Research Emphasizes the Need For Continuous Video Monitoring of At-Risk Patients

The latest version of the American Hospital Association Health Research & Educational Trust’s Falls With Injury Change Package introduces video surveillance as a change idea to increase the intensity and frequency of patient observation. HRET recommends video surveillance using a remote monitor tech who can speak with the patient and alert staff directly to intervene with the patient (p. 6 and p. 21).

In a new research study published in the September issue of the Journal of Nursing Care Quality, Lauraine Spano-Szekely, the Chief Nursing Officer of 245-bed Northern Westchester Hospital in Mt. Kisco, N.Y., and colleagues conducted an evidence-based improvement model for fall prevention that included:

• Organizational support for a fall prevention program
• Injury assessment
• Mobility assessment
• Assessment of medications that increase fall risk
• Consistent communication of risk factors
• Purposeful hourly rounding

Through small tests of change, program evaluation revealed a decreasing fall rate, except in the geriatric cluster of patients with confusion and impulsivity. Seeking evidence of cost effective-safety promotion technology for confused and impulsive patients to replace patient sitters, this research team implemented AvaSys, a patient-engaged video monitoring system. Through it, the team realized a 54% reduction in falls and a 72% reduction in sitter usage.

Their article, “Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement,” presents a population-based approach to fall prevention that also captures the “good catch” – when a fall was actually prevented because staff intervened. Interventions to protect geriatric, confused and impulsive patients from falls ultimately prevent injuries and save lives.

This new work stands in stark contrast to much of our previous experience with call lights, bed alarms, signage and sitter use, none of which moved the needle in any significant way on either falls or falls with injury, a wide array of studies have shown.

Given new information, we all need to stop over-reliance on universal fall precautions and start individualized and population-specific fall prevention programs. This research continues to confirm AvaSys’ effectiveness in patient safety and population-based outcomes.

Author:
Patricia A. Quigley, PhD, ARNP, CRRN, FAAN, FAANP, is a nursing consultant and a nationally recognized expert in fall prevention.