Clinical Questions About the Use of Video Monitoring for Patient Safety

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Video monitoring (VM) for patient safety appeared in nursing literature in 2009 after Hurricane Katrina, when a New Orleans medical center needed a quick solution for reducing the frequency of patient falls in the face of high patient volumes and a shortage of nursing staff.1 Although circumstances cannot be compared, similar challenges today leave nurses and administrators across the country asking whether video surveillance of patients is a feasible, cost-effective strategy to improve patient safety.
A variety of methods are used for VM, from hardwired cameras installed in designated patient rooms1,2 to mobile units that can be placed in any patient location.3,4 A decentralized monitoring design may use monitor screens at the unit’s nursing station that are visible to staff who frequent the area while simultaneously carrying out other duties1,5 or may use designated nursing personnel to constantly observe the monitors. Centralized monitoring designs include the use of a central monitoring area,2,4,6 in which patient care sitters (“tele-sitters”) or unlicensed VM technicians with specialized training perform the role of monitoring patients for safety. Interventions for averting patient harm include one or more of the following: responding immediately to the patient’s bedside,1,5 activating the nurse call system2 or other alarm,5 verbally redirecting the patient via 2-way speakers,1–3,7,8 telephoning nursing staff to elicit response,1,2,4 and overhead paging1,2 to alert available staff members in the vicinity to provide immediate assistance. Despite the wide range of individual processes, most often, VM captures only real-time imaging and does not produce video recordings; therefore, VM is included in hospitalization consent to monitor/observe patients and does not require additional consent or a physician’s order.

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