Reducing Fall Among Acute Rehabilitation Patients Through Implementation of a Video Monitoring System

Practice Problem: Falls are a significant healthcare issue that leads to substantial patient suffering and exorbitant health care expense. The Centers for Medicare and Medicaid Services (CMS) identify falls as preventable and not eligible for reimbursement. PICOT: The PICOT question that guided this project was: for acute rehabilitation inpatients (P), will the continuous use of video monitoring (VM) (I) compared to using bed alarms (C), decrease the fall rate by 10% (O) within six weeks of implementation (T)? Evidence: The practice recommendation for using a VM system as a primary intervention or part of a multifactorial comprehensive fall prevention strategy was recommended in the literature to improve patient safety and outcomes. Intervention: VM surveillance was used to decrease the prevalence of falls in moderate to high fall risk traumatic brain injury (TBI) patients on a rehabilitation unit. VM technicians verbally refocused patients and quickly alerted staff to potential falls. Outcome: The intervention achieved a 49% reduction in the hospital fall rate per 1,000 patient days, 65% in the rehabilitation fall rate per 1,000 patient days, 100% reduction in the TBI fall rate per 1,000 patient days, and a 30% reduction in cost for 1:1 sitter. Conclusion: This clinical project demonstrated support for the use of live VM surveillance to decrease fall rates on a TBI unit. As a result, this evidence-based project (EBP) project was recognized as improving the organization\u27s clinical care