Camera Surveillance for Safety; Its Impact on Fal Prevention, Staffing and Labor Expense

Purpose:
The purpose of the centralized camera surveillance program for specified patients was to reduce falls and patient elopement thru real time observation; reduce 1:1 sitter expenses, labor expense and to increase staff satisfaction on 7 acute care nursing units in an integrated safety net hospital.

Significance:
Falls in acute care account for the greatest number of non-fatal injuries in hospitals extending LOS, increasing costs of care, and pain and suffering. Falls rates on many of the units were above the NDNQI benchmarks. 1:1 sitters are commonly used for elopement risk and fall prevention.

Strategy and Implementation:
A multidisciplinary team led by the CNO operationalized the project. The Legal Department was consulted as needed. 168 cameras were installed in Acute Care patient rooms to support the 1:1 Sitter monitoring needs. A centralized camera surveillance room was constructed then staffed with CNAs who received training on surveillance and the use of the equipment in order to provide real-time surveillance monitoring. Expansion of the nurse- call system to the Patient Safety Surveillance room was necessary to facilitate the CNAs direct access to patients and nursing staff for patient and staff communication. Development and implementation of standard work for CNAs, Nurses and Transport Technicians was implemented. Other staff that provide direct patient care and non-patient care, such as housekeeping, were apprised of the camera surveillance program. Education was provided to staff by the educators. Camera surveillance was added to documentation as a fall prevention intervention.

Evaluation:
The program has resulted in saving approximately $20,000 in weekly labor costs. Staff satisfaction improved. CNAs in the camera surveillance room are highly motivated preventing falls and improving patient safety. Fall rates have decreased with 17.3% improvement from Quarter 3 2010 to Quarter 1 2011

Implications for Practice:
It is necessary to provide camera surveillance staff education with time allowed for adaptation. Staff may express concern their performance will be scrutinized. Use of technology for safety will grow in healthcare. It is important to consult the Legal Department during the program development.