Fall Prevention and Injury Reduction Utilizing Continuous Video Monitoring: A Quality Improvement Initiative.

BACKGROUND: Reduction of falls and fall-related injuries in hospital patients remains a priority. Consideration of technology via continuous video monitoring (CVM) is relevant for safe, quality care with favorable cost implications. LOCAL PROBLEM: Although fall rates were in the acceptable national safety standard guidelines, interventions were explored with the aim to further decrease falls using CVM. METHODS: The quality improvement project collected descriptive statistics. Run charts portrayed data trends for falls and injuries in 2-week increments over a 6-month period. INTERVENTIONS: Two-way cameras and a virtual sitter were used to observe fall risk patients. RESULTS: Implementation of CVM with virtual sitters depicted a 14% decline in fall rates and a 6% decrease in fall-related injury rates with positive budget implications. CONCLUSION: Cost savings, fall rates, and fall injury rates all improved with the inception of video monitoring.

Fall Prevention and Injury Reduction Utilizing Virtual Sitters in Hospitalized Patients: A Literature Review.

Falls and fall-associated injuries continue to occur in hospitals worldwide. Video monitoring using virtual sitters is a novel, cost-effective concept that has emerged as an intervention to address falls and maintain safety for hospitalized patients. This literature review examines the evidence regarding hospital-associated falls and fall-related injuries when video monitoring and virtual sitters were included as an intervention. Ten observational studies and two quasi-experimental studies (N = 12) were identified for inclusion from the Cumulative Index of Nursing and Allied Health Literature, Scopus, and PubMed databases. Overall, current evidence is focused on fall rates and cost savings. Eight studies demonstrated a fall reduction and the remaining three showed no statistical difference in fall rates with the use of video surveillance or virtual sitters. Cost savings for these interventions are based on the transition from 1:1 observation to virtual sitters; all 12 studies reported decreased overall costs transitioning to virtual sitters. Small sample size and limited studies are the primary limitations of current published evidence. As the novel clinical practice evolves and more hospitals are equipped with video capability, future research with virtual sitters should include expanded patient populations, a focus on fall-related injuries, and examinations of staff safety.

A feasibility study of Q-sort to determine recall of skin test results and environmental remediation education.

OBJECTIVE: Allergic asthma is common in urban minority children and evidence suggests that remediation tailored to the child's allergic profile is the most effective management strategy. The purpose of this pilot study therefore was to examine the caregiver's recall of their child's skin test results and the accuracy of planned remediation ∼4 months after testing. METHODS: Caregivers were asked to recall their child's skin test results ∼4 months after their skin testing but before any follow-up visit. A Q-sort was then used to determine the knowledge of the recommended remediation. In this Q-sort, caregivers placed 52 cards, each representing one intervention for an indoor allergen, on a response board that prioritized the interventions. At the conclusion of the Q-sort, caregivers received feedback on the accuracy of their recall and prioritization. RESULTS: African American caregivers (5 females; mean age 33.6) of 5 children (4 males; mean age 7.8) were enrolled. No caregiver's recall of skin test results was concordant with the actual results for type or number of allergens. Caregiver's accuracy in prioritizing strategies was 33-100% for cat dander, 40-70% for molds, 70-87% for dust mite allergens, and 100% for the one dog allergic child. Subjects preferred Q-sort to traditional methods of receiving remediation education. CONCLUSIONS: Caregivers do not accurately recall skin test results and this may, in part, impede their ability to implement appropriate interventions. A low-literacy game-style approach is a novel strategy to provide complex teaching that warrants further investigation.

Florence's Candle: educating the millennial nursing student.

Florence Nightingale's Candle serves as a symbol of the nursing profession. It is utilized in different venues, including nursing education. The Millenial students in today's higher education setting, particularly in nursing, would benefit from applying its symbolism in the classroom and in their nursing careers. The concepts of technology, discovery, and coming together as a nation are discussed as they relate to nursing education and to Florence's candle of caring.