Cournan Michele, Fusco-Gessick Benjamin, Wright Laura
Sunnyview Rehabilitation Hospital, Schenectady, NY, USA.
Rehabil Nurs. 2018 Mar/Apr;43(2):111-115. doi: 10.1097/RNJ.0000000000000089.
Falls are a major safety issue in rehabilitation settings. Patients receive mixed messages-try to be as independent as possible, but don't do anything in your room without calling for assistance. Despite the use of multiple falls interventions at this facility, the fall rate remained high. To impact this rate, the facility implemented a video monitoring system. This system allows for patients at risk for falling to be monitored from a remote location. The monitor technician is able to speak to the patient directly and/or contact staff members to respond to the room, preventing a fall.
Sequential cohort design.
Fifteen video monitoring units were installed on high-risk units in a 115-bed inpatient rehabilitation facility. Total falls and falls rates were tracked and reported pre- and postimplementation.
Over a 21-month period prior to implementing the video monitoring system, the average hospital-wide rate of falls was 6.34 per 1,000 patient-days (SD = 1.7488). After a year of usage, that average has decreased to 5.099 falls per 1,000 patient-days (SD = 1.524). The reduction in falls was statistically significant. In addition, there have been significant cost savings by reducing sitter usage.
Video monitoring can improve patient safety by decreasing falls; decreasing sitter usage and cost; and improving patient, family, and staff satisfaction.
Falls are a significant issue in rehabilitation settings, and current fall prevention strategies fall short of reducing fall rates. Implementation of new video monitoring technology can help reduce fall rates in inpatient rehabilitation settings.
在康复环境中，跌倒属于重大安全问题。患者收到的信息相互矛盾——尽量保持独立，但在房间里不寻求帮助就不要做任何事。尽管该机构采取了多种预防跌倒措施，但跌倒率仍然很高。为了降低这一比率，该机构实施了视频监控系统。该系统可对有跌倒风险的患者进行远程监控。监控技术人员能够直接与患者对话和/或联系工作人员前往病房，从而预防跌倒。
序贯队列设计。
在一家拥有115张床位的住院康复机构的高风险病房安装了15个视频监控单元。在实施前后对跌倒总数和跌倒率进行跟踪和报告。
在实施视频监控系统前的21个月期间，全院平均跌倒率为每1000患者日6.34次（标准差=1.7488）。使用一年后，该平均值降至每1000患者日5.099次跌倒（标准差=1.524）。跌倒率的降低具有统计学意义。此外，通过减少陪护人员的使用，成本显著降低。
视频监控可通过减少跌倒、降低陪护人员使用和成本以及提高患者、家属和工作人员的满意度来提高患者安全。
跌倒在康复环境中是一个重大问题，目前的预防跌倒策略未能降低跌倒率。新视频监控技术的实施有助于降低住院康复环境中的跌倒率。
