Topic: Fall Prevention

Effort Continues to Prevent Patient Falls within Phoebe Putney Health System

ALBANY — The Phoebe Putney Memorial Hospital Board of Directors got its first look Wednesday at a new piece of technology meant to help prevent patient falls.

The AvaSys Telesitter® program, which has 12 units between the main hospital and Phoebe North, works by putting more eyes on patients.

Equipped with an infrared camera and two-way audio, it is set up in rooms of patients identified as high risk for falls. One technician can monitor live feeds on the units from those rooms at a central station.

If a patient tries to get out of bed, the observer can interact with the patient with a reminder to wait for assistance or sound an alarm for immediate staff attention. Patients in imminent danger receive an alarm, which signals the staff to head quickly to the patient’s room.

“Within seconds, someone is in the room,” April Little, a central staff manager for Phoebe Putney Health System, said of the alarm.

Read the full article to learn more.

Outcomes of Clinical Nurse Specialist Practice in the Implementation of Video Monitoring at an Academic Medical Center

Outcomes of Clinical Nurse Specialist Practice in the Implementation of Video Monitoring at an Academic Medical Center
Purvis S, Kaun A, McKenna A, Viste JW, Fedorov E. Clin Nurse Spec. 2018;32(2):90-96.

Challenge

Caring for patients with increased safety needs and those needing 1:1 observation is a challenge to hospital resources. One of the most expensive safety practices in acute care hospitals in the United States is the use of constant observation. Most programs are developed with patient safety in mind, but the costs increase over time.

What’s more, the literature on constant observation shows very little proof of improvement in successful outcomes, such as fewer falls.

Solution

Clinical Nurse Specialists identified 8 units for a pilot program using video monitoring. During the 3 quarters following the implementation of video monitoring, there was a significant impact on resource utilization. With the use of full-time patient safety attendants, there was an approximate annual savings of $211,000 and no increase in the number of falls.

TeleSitter® System Keeping Patients Safe

LAKE CHARLES, LA (KPLC) – Patient safety is paramount in hospital settings and traditionally, it has taken one-to-one care 24 hours a day for some of the most at-risk patients.

That can tie up skilled nursing staff from other demands and that is why a new video monitoring system has been launched at Lake Charles Memorial Hospital.

It is called the AvaSys Telesitter® Solution and through a two-way audio system, video camera, and central monitoring station, Memorial nurse manager, Tressy Bergeron, is able to keep an eye and ear on up to 12 patients at one time.

Watch the full story here. 

Remote Video Monitoring: A Novel Approach in Fall Prevention

Remote Video Monitoring: A Novel Approach in Fall Prevention
K Bradley. J Continuing Education in Nursing. 2016;47(11):484- 486.

Challenge

In-hospital safety sitters are associated with a range of disadvantages. Safety monitors are a valuable resource in maintaining patient safety. Yet, there are limitations:

  • They are typically used in hospitals to directly observe 1 to 2 patients to prevent patients from falling or injuring themselves.
  • As a resource, they are not always available to nurs­ing staff due to the difficulty in predicting when they are needed.
  • Their use increases the costs of delivering care.

Hence, this frequently results in ac­quiring per diem staff or reassigning staff to monitor fall risk patients. Such alterations in staffing can lead to job dissatisfaction.

Solution

Remote Video Monitoring with AvaSure. Remote video monitoring provides a live-stream video of patient activity as an additional safety intervention in preventing falls.

This technology provides an innovative fall prevention strategy that allows the sitter to moni­tor multiple patients at one time.

It is important to keep in mind that sitters require training to use the software functions, such as navigating the camera and alert options, and have the confidence needed to verbally intervene when they rec­ognize unsafe patient behaviors. Additionally, the remote sitter must be able to multitask, such as demonstrating competencies using the PC while monitoring the television screen, allowing them to visualize each of the patients being monitored.

While remote video monitoring may not completely end patient falls, it is an additional resource that can be used in the clinical ar­senal of fall interventions—and having an extra set of eyes to monitor patient activity is always helpful.

Conclusions

This technology provides an innovative fall prevention strategy that can improve fall-related patient outcomes and sit­ter costs.

Video Monitoring to Reduce Falls And Patient Companion Costs For Adult Inpatients

Video Monitoring to Reduce Falls and Patient Companion Costs for Adult Inpatients

Votruba, L., Graham, B., et al. (2016). Nurs Econ, 34(4), 185-189

Abstract

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.

Sitter Reduction Through Mobile Video Monitoring: A Nurse-Driven Sitter Protocol and Administrative Oversight

Sitter Reduction Through Mobile Video Monitoring: A Nurse-Driven Sitter Protocol and Administrative Oversight
Burtson PL, Vento L. J Nurs Adm. 2015;45(7-8):363-369.

Challenge

Sitters are a variable staffing resource that can be difficult to predict and accurately budget. Given multiple pressures to reduce self-injury from falls and other high-risk safety concerns, such as pulling tubes and lines, elopement risk, and suicide risk, the UC San Diego Health System (UCSDHS) implemented a patient sitter program. Sitters were used to closely observe 1 or more patients in direct line of sight. Yet, the costs of these sitters continued to rise.

  • Annual sitter costs in 2012 were estimated to be $3,197,515 across both UCSDHS locations

Therefore, nursing leaders initiated an evaluation of the sitter program with the aim of recommending and implementing new technologies or changes in current practice that would maintain or improve patient safety while reducing costs of care.

Solution

Goals for the video monitoring project included reducing sitter costs and outperforming national benchmarks and nursing-sensitive indicators (falls, falls with injury, and restraints).

  • In the first year (9 of 12 months implementation), there was a 24% reduction in combined video monitor technician and sitter staffing, for an estimated savings of $771,919
  • In the second year, the program realized a 54% reduction in staffing, for an estimated savings of $1,718,823
  • The return on investment for these units alone was 8.9 times the initial investment (calculated based on combined costs for video monitor technician and sitter staffing)
  • 26% (average) reduction in falls with injury—outperforming or equaling benchmarks per 1000 patient days

Conclusion

The UCSDHS experience has demonstrated that nursing culture can shift and trust in the effectiveness of a new technology to address patient safety, such as video monitoring.