A S.A.F.E. alternative to sitters

Nadler-Moodie, Marlene; Burnell, Lori; Fries, Joyce; Agan, Donna L.

doi:10.1097/01.numa.0000359209.42026.e9

Cited by 20 publications

(23 citation statements)

References 4 publications

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“…units. (23) This model is based on placing all patients who require constant or very close observation in close proximity to one another, either in a single room or unit in the presence of nursing staff, which provides for continuous or close monitoring for these patients. With the implementation of these SAFE units, the use of sitters was decreased significantly, in addition to a reduction in restraint use.…”

Section: Resultsmentioning

confidence: 99%

The Role of Sitters in Delirium: an Update

Carr

2012

Can Geri J

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PurposeThe concept behind constant observation is not new. Whilst traditionally performed by nursing staff, it is now commonly performed by sitters. Details surrounding the usage, job description, training, clinical and cost effectiveness of sitters are not known; hence the reason for this review.MethodsA literature search was performed in MEDLINE, Cochrane Database of Systematic Reviews, and PubMed from the years 1960 to October 2011. The definition for sitter used in the articles was accepted for this review.ResultsFrom this review, it is evident that sitters are being employed in a variety of settings. The question of which type of person would provide the most benefit in the sitter role is still not clear; whilst sitters have typically included family and volunteers, it may be trained volunteers who may offer the most cost-effective solution. The paucity of information available regarding the training and assessments of sitters and the lack of formal guidelines regulating sitters’ use results in a lack of information available regarding these sitters, and current available evidence is conflicting regarding the benefits in terms of cost and clinical outcome. The only strong evidence relating to clinical benefit comes from the use of fully-trained sitters as part of a multi-interventional program (i.e., HELP)ConclusionsCurrent evidence supports a role for the sitter as part of the management of patients with delirium. The most cost-effective sitter role appears to be trained volunteers. Further research is needed to determine the specific type of training required for the sitter role. The creation of a national set of regulations or guidelines would provide safeguards in the industry to ensure safe and effective patient care.

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Section: Resultsmentioning

confidence: 99%

The Role of Sitters in Delirium: an Update

Carr

2012

Can Geri J

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“…They are also used for patients who are unable to follow directions or are non-compliant, are at risk to falls, are elopement risks, are violent, have impaired vision and hearing and are deemed to be at risk of removing medical devices. [3][4][5][6][7][8][9] Although most commonly used in hospitals in the United States (U.S.), the practice has been described in hospitals in Saudi Arabia, Australia, Scotland Canada, and Taiwan. A survey of 102 hospitals revealed that all used some form of sitters to provide direct patient surveillance.…”

Section: Introductionmentioning

confidence: 99%

“…[6,10,14,22] As such, it is important for nurses to consider less expensive interventions that have demonstrated success in preventing harm such as symptom triggered protocols, staff education, and video monitoring. [9] The intervention implemented in the hospital where the current study was performed, was engaged to decrease the use of sitters in the study hospital was video monitoring.…”

Section: Introductionmentioning

confidence: 99%

“…[4] Hospitals in the United States have reported spending $500,000 to over $2,000,000 in costs related to sitters. [6,9,12] Clearly, the use of sitters to provide constant surveillance is costly to hospitals.…”

Section: Introductionmentioning

confidence: 99%

“…[16][17][18] The literature suggests that a decrease in the use of sitters is possible, while at the same time, maintaining or improving patient safety. [19] These strategies include: symptom triggered practice guidelines that offer early pharmacotherapy management and increased assessments; [20] medical and nursing psychiatric consults or protocols; [3,6,14] and video monitoring. [9,11,19] The use of unpaid adults who volunteered or who were family/friends has been found to be cost effective, however, the reliance of volunteers to staff units around the clock is difficult, [16,21] Goodlett, Robinson, Carson, and Landry noted that when in-room sitters were replaced with video monitoring, the fall rate decreased by 6%, although the difference was not statistically significant.…”

Section: Introductionmentioning

confidence: 99%

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A comparative study of patient sitters with video monitoring versus in-room sitters

Davis

Kutash²,

Whyte³

2016

JNEP

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Background/Objective: Use of in-room sitters to prevent patient's fall or injury is widespread in hospitals. This practice, however, is expensive, seldom reimbursed, controversial in the literature, and not supported by a strong body of evidence. The objective of this study was to determine the prevalence of patient falls and self-harm using in-room sitters and video monitoring and associated costs. Methods: In-room sitters and video monitoring was studied in two adult, medical surgical units, using an evaluative research design, with quasi-experimental approach. Descriptive statistics and independent samples t tests were performed for analysis. Results: The study identified no statistically significant difference in the prevalence of falls or self-harm events when video monitoring was used to provide constant observation. There was statistically significant lower cost per patient day with video monitoring. Conclusions: Video monitoring is less expensive than sitters and does not impose a patient safety risk for falls or self-harm.

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