Running head: TELESITTERS 1

Effectiveness of TeleSitters on Fall Prevention

Kamari Parris

Bon Secours Memorial College of Nursing

NUR 3207

September 28, 2014

"I Pledge"…
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Abstract

Fall Prevention has been a patient safety issue that clinicians have been faced with on an ongoing

basis for the past several years. Lately it has gotten to a point that hospitals are losing

government funding due to their inability to reduce their fall rates. Since 2008, Medicare has

refused to pay the extra cost associated with injury due to a fall, which averages $27, 000 for

each incident (Sloan, 2015). Due to these regulations, hospitals have become creative in ways to

combat this issue. Practices that hospitals use to reduce falls include the use of sitters, bed

alarms, appropriate room assignments, wearing non-skid footwear when ambulating, and

keeping the call bell in close proximity of the patient. In 2008, AvaSys developed a fall

prevention device called a TeleSitter, which is a "remote patient observation and communication

device that enables visual and audio monitoring of patients at risk for falls" (Sloan, 2015 n.p.).

By using this device an “in room” is no longer necessary. This paper will discuss the benefits of

using the TeleSitter in reducing patient falls.

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Fall Prevention has become a top priority of hospital systems in the United States since

Medicare adjusted its regulations. As of 2008, they don’t reimburse hospitals that patients suffer

a fall with injury (Sloan, 2015). Therefore it was critical that hospitals explore new options to

reduce their fall rates. The introduction of the TeleSitter has provided organizations with the

ability to improve patient safety and also reduce costs from the need of sitters. Organizations are

still being introduced to the idea of video monitoring and it will be interesting to see which

direction we will follow with this new technology. The Telesitter is being used at Memorial

Regional and St. Francis Medical Center, both Bon Secours facilities where fall prevention is a

top priority for patients.

First, it is important that the TeleSitter is used on the appropriate patient population. In

order for the TeleSitter to safely monitor a patient they must be able to follow directions in their

confused state and can be easily redirected without physical guidance (Goold, 2014). By

determining the appropriate placement of the Telesitter good stewardship is practiced and the

resource of an in-room sitter is saved for those that may be violent, suicidal or are hard of

hearing. A nurse at Memorial Regional whom was responsible for helping to implement their

Telesitter program reported that falls were decreased from this system, but not totally prevented

(D. Cofield, personal communication, October 2, 2016). He agrees that it is important to assess

the appropriateness of the application of this product.

Research studies so far have been very favorable of the fall prevention qualities the

TeleSitter provides. St. David’s North Austin Medical Center in Austin, Texas purchased 10 of

the devices and in turn did not experience any falls for six months following initiation (Goold,

2014). Nurses appreciate the idea of having an extra set of eyes on their patient because they can
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be warned immediately of a patient in danger. In a case study done by Denver Health over 18

months reported a 5.6 times return on the purchase of the monitor. They also reported the

prevention of 57 falls from using the telesitter (Burtson&Vento, 2015).

In addition to its fall reduction qualities, the TeleSitter has proven to reduce hospital costs

for nursing units. Initially, a unit will have to pay $74, 018 for the cost of the equipment and

associated training. This quickly will result in a return on the investment because it reduced the

need of a sitter by 8.7% (Burtson&Vento, 2015).

So far, by implementing the use of the Telesitter program hospitals have benefited from a

reduction in falls, and saving money from reduced in-room sitters. Although the telesitter

program has been successful, studies have shown that multicomponent interventions decrease

falls by 30% (Miake, Hempel, Ganz, Shekelle, 2013). Multicomponent interventions include

using a combination of methods to reduce fall rates such as, patient education, bedside risk sign,

staff education, alert wristbands, toileting schedules, fall review, and movement alarms to name

a few. An article by Annals of Internal Medicine suggests, although multicomponent

interventions reduce falls, future research would need to be performed to figure out which

combination of these interventions works best (Miake, Hempel, Ganz, Shekelle, 2013). Another

Memorial Regional Nurse supported combining several safety practices to reduce falls after

witnessing a patient a fall while being monitored by a telesitter. She reported that the patient had

gotten their leg stuck in a recliner while being monitored and suffered a fall. In this instance, the

patient would have benefited from having several fall prevention resources in use such as a

movement alarm. The only way this patient’s fall was detected was by another nurse who heard

the patient calling for help and found her laying on the floor (S. Tracy, personal communication,

October, 2 2016).
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In conclusion, the introduction of the telesitter has made a vast improvement in the

incidence of inpatient falls but will be most effective if used in conjunction with other fall

reduction methods. Ultimately evidence suggests that the best way to prevent falls is by “prompt

response from nursing staff to a patient’s request for assistance” (Rheaume & Fruh, 2015) p.320.
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References

Burtson, P. L., Vento, L. (2015). Sitter Reduction Through Mobile Video Monitoring. The

Journal of Nursing Administration. (45)7/8.

D. Cofield, personal communication, October 2, 2016

Gold, N. (2014). Via Christi using TeleSitters to improve patient safety. Via Christi Health,

Retrieved from https://www.viachristi.org/blog.

Miake-Lye IM, Hempel S, Ganz DA, Shekelle PG. Inpatient Fall Prevention Programs as a

Patient Safety Strategy: A Systematic Review. Ann Intern Med. 2013;158:390-396.

doi:10.7326/0003-4819-158-5-201303051-00005

Punke, H. (2015). Zero injuries from patient falls: One hospital demonstrates how it’s possible.

Infection Control & Clinical Quality. Retrieved from:

http://www.beckerhospitalreview.com

Rheaume, J., Fruh, S. (2015). Retrospective Case Reviews of Adult Inpatient Falls in the Acute

Care Setting, Medsurg Nursing, (24)5. P.318-324.

Sloane, T. (2015). Video Monitoring Reduces Patient Falls by 35 percent, Study Shows.

AvaSure. Retrieved from avasure.com/video-monitoring-reduces-patient-falls-by-35-

percent

S. Tracy, personal communication, October 2, 2016

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