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Negative outcomes occur when hospitalized patients suffer a fall. Video monitoring is increasingly used for fall prevention. A literature review was performed on the effectiveness of video monitoring at preventing falls. Considerations are presented for implementation of video monitoring.
Key Words: Fall prevention, hospital, video monitoring, video monitoring technician, quality improvement, implementation.
Any nurse who has had a patient fall in the hospital, especially a fall that resulted in injury, understands how significant the problem is. It is estimated that about 700,000 to 1,000,000 hospitalized patients fall in the United States every year (Ganz et al., 2013), 30-50% of hospital falls result in injury (The Joint Commission, 2015), a fall without injury adds $13,000 more to the cost of hospitalization, and a fall with injury adds $27,000 more (Trepanier & Hilsenbeck, 2014). Additional costs occur when an unwitnessed fall requires further labs and diagnostics to determine if an injury occurred. On top of that, more costs can occur when a fall leads to litigation and possible settlements.
Fall prevention is The Joint Commission's national patient safety goal. Falls with serious injury are considered a sentinel event (The Joint Commission, 2015). The Centers for Medicare & Medicaid Services (2019) added falls to the list of hospital acquired conditions in 2008 and limit reimbursement for care. Hospitals are challenged to develop effective fall prevention strategies with responsible use of financial resources.
Universal fall precautions typically include fall education at admission, frequent standardized fall risk assessment, hourly rounding, and safe patient handling. Fall precautions for high risk patients typically include bed and chair alarms, specialized armbands, and sometimes sitters for impulsive patients (Ganz et al., 2013). Evidence in the effectiveness of sitters at preventing falls is inconclusive. In one systematic review of 12 studies with methods including pre-post comparative, retrospective descriptive, retrospective epidemiological, and prospective descriptive, 10 concluded that a decrease in sitter use did not correspond with an increase in patient falls (Lang, 2014).
An increasingly used fall prevention method is video monitoring (VM). VM allows for remote, unrecorded, real-time monitoring of patients similar to a security surveillance operation. With VM, one sitter, or video monitoring technician (VMT), can monitor multiple patients at high risk for falls. The use of VMTs would allow more patients to...