Title : Transforming nursing practice and patient safety through centralized telesitter technology
Abstract:
Nurses are at the forefront of transforming healthcare by adopting emerging technologies to enhance care delivery. One example is a nurse-led initiative at WHS that implements Centralized Telesitters—an innovative virtual patient monitoring solution designed to improve patient safety, streamline workflows, and reduce costs through effective fall prevention. Nurses played a central role in designing and implementing the telesitter program. Remote monitoring orders, based on frontline nursing assessments, empower teams to address patient safety risks in real-time and proactively. The program expanded observation capabilities and enabled timely behavioral interventions for patients at high risk of falling and those with low to moderate behavioral health needs. Before implementation, WHS recorded a 2.20 falls rate per 1,000 patient days. In the first year, that rate rose to 2.63 falls per 1,000 patient days, reflecting improved identification of at-risk behaviors and highlighting areas for optimization. The increase may be attributed to the COVID-19 pandemic, which led to slower response times for PPE donning and doffing. By the second year, the fall rate decreased by 12.17% to 2.31 falls per 1,000 patient days, demonstrating measurable improvement in patient outcomes. This initiative exemplifies the impact of nursing leadership in care model redesign, resource optimization, and patient safety enhancement through digital innovation. Centralized telesitters support real-time surveillance and prompt, team-based responses to unsafe behaviors. Mobile cameras with two-way communication allow immediate interaction and early de-escalation, maintaining a patient-centered approach. Telesitter programs provide proven clinical and financial benefits. Research by Sand-Jecklin et al. (2018) shows video monitoring enhances perceived safety and reduces fall incidents, while Miller et al. (2021) report up to a 14% fall rate reduction and fewer injuries. The average cost of an inpatient fall is $62,521, including $35,365 in direct costs, meaning ten preventable falls could save $625,210. These figures highlight the significant cost avoidance potential and value of telesitter programs. This nursing-led digital transformation model enhances safety, improves efficiency, and supports workforce sustainability, offering a scalable framework for applying similar technologies in patient care.
