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NURSING UNITS: What are telesitters? Why are they used?

Patient sitters are used in hospitals for patients at risk of falls or other harmful behavior.  Some hospitals have begun to explore the use of virtual sitter technology, or telesitters, to reduce sitter costs while maintaining high quality care.  I thought the following was an interesting breakdown of the reasons that sitters were assigned to patients at one large teaching hospital – UC San Diego Health System (UCSDHS) – a Magnet hospital.  These percentages were based on data collected for one month in 2011:


  • 34 percent (risk for elopement)
  • 30 percent (fall risk)
  • 16 percent (pulling out tubes or lines)
  • 10 percent (harm to self)
  • 10 percent (other)

The purpose of this study was evaluate a way to decrease sitter costs while maintaining high patient safety rates by using a video cart-based monitoring system (implemented in 2012) and also by revising the sitter protocol.  Six mobile carts were put into use at an initial start-up cost of about $83,000 in the first two years.  Return on investment and trends in fall rates are discussed in this article.

St. David’s HealthCare (Austin, Texas) has implemented a virtual sitter program, also a cart-based technology with a camera and 2-way audio.  The slide presentation noted below includes a tiered chart that shows the criteria to determine if a patient is in need of a virtual sitter.


[About UCSDHS]  Burtson, P.L., and Vento, L. (2015, July-Aug.). Sitter reduction through mobile video monitoring: A nursing-driven sitter protocol and administrative oversight. JONA. Journal of Nursing Administration, 45(7/8), 363-369. Full text can be purchased here: http://journals.lww.com/jonajournal/Abstract/2015/07000/Sitter_Reduction_Through_Mobile_Video_Monitoring_.5.aspx  Table here: http://download.lww.com/wolterskluwer_vitalstream_com/PermaLink/JONA/A/JONA_45_7_2015_05_27_BURTSON_14259_SDC1.pdf

[About St. David’s]  McCurley, J. (2015). A new approach to fall prevention in inpatient care. Retrieved from http://tdshshealthcaresafetyconference.com/Documents/8-20_1120-A%20New%20Approach%20to%20Fall%20Prevention-McCurley.pdf

[More about St. David’s]  Punke, H. (2015, Apr. 7). Zero injuries from patient falls: One hospital demonstrates how it’s possible. Becker’s Infection Control & Clinical Quality. Retrieved from http://www.beckershospitalreview.com/quality/zero-injuries-from-patient-falls-one-hospital-demonstrates-how-it-s-possible.html  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

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