Reducing Patient Falls Using a Video Monitoring System at a Inpatient Pediatric Unit

Purpose:
The identified issue involved falls in the pediatric rehabilitation population along with excessive sitter usage and associated expense.

Significance:
This issue is very important due to associated improvements with our fall rate and decreasing cost for sitter usage. Very little research has been done related to decreasing sitter usage and patient outcomes.

Strategy and Implementation:
In December 2009 a video monitoring system, which consisted of digital cameras mounted in five designated patient rooms and a centrally located monitor was purchased and installed. The objectives of this video monitoring system were to afford continuous visual observation of patients by remote staff; as well as, to supplement the need for dedicated room sitters. A fall prevalence rate per 1,000 patient days in 2009 was 2.16.In addition, the total room sitter usage in 2009 was approximately 6.7 full-time equivalents totaling over $328,000 in costs. In 2010 the project was expanded reviewing the total number of patients video monitored and unmonitored and associated fall rates. The fall rate was calculated based on the nine patient falls reported in Patient Safety Net through the United Healthcare Consortium over the 4,055 patient days in 2010. Only 2 out of the 9 patient falls reported were monitored through the new video system.

Evaluation:
The project has been a success. Success was measured by looking at fall rates for monitored versus unmonitored patients. Also associated cost for sitter usage was taken into consideration which totaled a savings of 328K.

Implications for Practice:
Alternative measures utilized for high risk fall patients in the pediatric population which includes a video monitoring system. Sitters not utilized for patients. Significant cost savings identified.