Fall Prevention and Injury Reduction Utilizing Virtual Sitters in Hospitalized Patients: A Literature Review

Fall Prevention, Sitter Reduction

May 28, 2021

A literature review showcasing important evidence that virtual monitoring is standard of care.

Fall Prevention and Injury Reduction Utilizing Virtual Sitters in Hospitalized Patients: A Literature Review
Quigley BH, Renz SM, Bradway C. Comput Inform Nurs. 2021;39(12):929-934.


Falls remain one of the most well-documented hospital incidents among patients. Yet more than one-third could be prevented.

 In-hospital falls are a global problem—and the statistics in the United States alone are staggering:

  • There are up to 1 million falls each year, which translates into 2.3 to 7 falls per 1000 inpatient hospital days
  • There are nearly 11,000 deaths per year from an injury sustained in a fall during hospitalization
  • Costs to Medicare for falls exceeded $31 billion in 2015
  • Falls and fall-related injuries add 6 to 12 inpatient days to a hospital stay, with costs of more than $30,000 per incident

What’s more, the US Joint Commission has suggested that as many as 33% of falls could be prevented.


Video monitoring using virtual sitters is a novel, cost-effective approach to reduce the risk of falls and maintain safety for hospitalized patients. In a review of the clinical literature, 12 articles that focused on a study or quality improvement project utilizing continuous video monitoring with virtual sitters to prevent falls were analyzed.

The change from 1 sitter per patient to 1 virtual sitter per a cohort of patients consistently demonstrated a decrease in costs, with some studies reporting a decrease in fall rates.


Prevention of falls and fall-related injuries is a hallmark of quality patient care and an expected outcome of hospitalization. Video sitter surveillance was developed for just this reason, while also offering a cost-effective alternative to the use of 1:1 sitters.

This literature review supports the use of video surveillance/virtual sitters as a strategy to decrease or plateau fall rates with an added cost savings benefit. It is likely that future use of video surveillance to maintain safety, prevent or minimize falls and fall-related injuries, and achieve high-quality patient care will expand to other clinical scenarios, such as seizures, substance withdrawal, self-medicating, self-harm, and abuse situations, or to monitor patients in isolation.

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