Outcomes of Clinical Nurse Specialist Practice in the Implementation of Video Monitoring at an Academic Medical Center

Abstract

Clinical nurse specialists were successful in collaborating with interdisciplinary colleagues to support the development of a Constant Observation Program that included video monitoring. In addition, clinical nurse specialists developed documentation, policies, and procedures to support this new technology. Success was evidenced by support of and growth of the program over time.

Fall Prevention and Injury Reduction Utilizing Continuous Video Monitoring

“…Virtual sitters may continue as a fall prevention strategy, as the literature supports many hospitals experienced encouraging results in terms of fall reduction 6–11. In addition, the cost savings for hospitals that introduced CVM were convincing 6–18…”

“…All studies calculated falls per 1000 patient-days 6. Interestingly, of the 12 studies, only 5 found a decline in the number of falls6–11; however, none of the studies showed an increase in falls 6–18…”

“…In addition, all 12 studies reported a decrease in overall costs transitioning from 1:1 sitters to virtual sitters using CVM 6–18. Although each study reported monetary savings and recouped initial investments for cameras, monitors, and training, there were important differences.…”

“…Multiple methods facilitated determination of assignment for CVM and virtual sitter surveillance. For example, some studies developed algorithms for inclusion per individual institution10,11,16 or unique patient populations 10. Other studies chose to use nursing judgment rather than formulate specific guidelines7,12 or relied solely on a fall risk assessment tool to determine eligibility for CVM 11,15.…”

Continuous Video Monitoring

“…Research is limited to highlevel certainty regarding implementation success, for example, utilization of advanced practice nurses to promote interdisciplinary collaboration and the development of successful policy and procedure. 11 However, details on how to sustain and/or expand a program do not exist in the current literature. The next section of this article explains the metrics we used to show the value of CVM in our organization, which allowed for expansion of our program with additional purchase of cameras and expansion of our VMT labor pool.…”