Attached.
Attached.

Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls
Submitted by
Njideka Laura Akubuilo

Direct Practice Improvement Project Proposal
Doctor of Nursing Practice

Grand Canyon University
Phoenix, Arizona
June 05, 2019

iv

© by Your Full Legal Name (No Titles, Degrees, or Academic Credentials), 2013
All rights reserved.

GRAND CANYON UNIVERSITY

The Direct Practice Improvement Project Title Appears in Title Case and is Centered

by
Insert Your Full Legal Name (No Titles, Degrees, or Academic Credentials)

has been approved

December 31, 2018

APPROVED:
Full Legal Name, Ed.D., DBA, or Ph.D., DPI Project Chairperson
Full Legal Name, Ed.D., DBA, or Ph.D., Committee Member
Full Legal Name, Ed.D., DBA, or Ph.D., Committee Member

ACCEPTED AND SIGNED:
________________________________________
Lisa Smith, PhD, RN, CNE
Dean and Professor, College of Nursing and Health Care Professions
_________________________________________
Date

iv
Abstract
Patient falls remains as one of the major challenges to the healthcare sector. Patient
falls has many negative consequences on the patient as well as the health institution.
Patients endure extended hospital stays, head injuries, broken limbs, increased pain and
suffering, and many other problems. This therefore necessitates that new and better
interventions be coined to help in reducing the rate of patient falls. This project focusses
on understanding the effectiveness of Telesitter systems, identifying the challenges
associated with the Telesitter monitoring systems, as well as identifying the solutions to
the identified problems. This project uses the Nightingale environmental theory of nursing
and Newman’s theory of health as expanding consciousness. The findings from this project
indicate that combining the use of Telesitter systems and Fallarm tactile sensor wearable
device can help to enhance the effectiveness of Telesitter systems as a falls reduction
intervention. The Fallarm device helps by sounding an alert whenever the fall risk of the
patient is escalated. This intervention will ensure that patients with high fall risk probability
are closely monitored through the Telesitter monitoring system as well as the tactile sensor
device, ensuring that their probability of falls is greatly reduced. This recommendation is
also in line with Johnson (2014), whose research found out that the best approach to solve
patient falls is using multi-interventional approach. Implementing the two technological
interventions in the healthcare system is deemed to have invaluable benefits in reducing
falls rate as well as boosting quality of care.

Keywords: Patient falls, Fallarm, Telesitter monitoring systems, fall prevention, acute care,
and fall risk.

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Dedication
I dedicate this project to all patients receiving care in the critical care unit,
progressive care unit, and the oncology unit. They are more prone to falls and I am
confident that the findings from this project will help to reduce fall risk. I am sure that
successful implementation of the proposals in this project will help in catering for the
needs of the targeted patient population, thus reducing falls as much as possible.

vi
Acknowledgments
I take this precious opportunity to thank God Almighty for his infinite mercy and
strength He gave me throughout this project. I also seize this opportunity to thank my
supervisor and the committee team for their dedication and support, and immense
contribution academically in approving this project. They have helped me shape this
project into a professional scholarly project and I am confident that it will help to
transform healthcare delivery in the acute care environment. I also thank my parents for
their contributions spiritually, morally, and financially. I also thank my siblings and
friends for their spiritual and moral support during the entire time of the project; I
appreciate all of you. God Bless you all.

vii
Table of Contents
List of Tables ..................................................................................................................... xi
List of Figures ................................................................................................................... xii
Chapter 1: Introduction to the Project ..................................................................................1
Introduction ....................................................................................................................1
Background of the Project .............................................................................................3
Problem Statement .........................................................................................................5
Purpose of the Project ....................................................................................................6
Clinical Question ...........................................................................................................7
Advancing Scientific Knowledge ..................................................................................9
Significance of the Project ...........................................................................................10
Rationale for Methodology ..........................................................................................12
Nature of the Project Design ........................................................................................13
Definition of Terms......................................................................................................14
• Telesitter ...................................................................................................14
• Patient-falls...............................................................................................14
• Caregiver ..................................................................................................14
• Impromptu patient calls ............................................................................14
• Impromptu caregiver calls ........................................................................14
• Elderly patients .........................................................................................14
• Panic .........................................................................................................14
• Anxiety .....................................................................................................15

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• Fear ...........................................................................................................15
• Fall rate .....................................................................................................15
• Fallarm device ..........................................................................................15
Assumptions, Limitations, Delimitations ....................................................................15
Summary and Organization of the Remainder of the Project ......................................16
Chapter 2: Literature Review .............................................................................................18
Introduction to the Chapter and Background to the Problem ......................................18
Theoretical Foundations and/or Conceptual Framework .............................................22
Review of the Literature ..............................................................................................24
Falls and their effects on patients and hospitals.............................................24
Factors related to falls. ...................................................................................28
Fall prevention interventions including Telesitter systems, Fallarm wearable
devices, and fall risk assessments. .............................................................................33
Literature findings on the variables. ..............................................................37
Summary ......................................................................................................................41
Chapter 3: Methodology ....................................................................................................45
Introduction ..................................................................................................................45
Statement of the Problem .............................................................................................47
Clinical Question .........................................................................................................48
Project Methodology....................................................................................................50
Project Design ..............................................................................................................50
Population and Sample Selection.................................................................................51

ix
Instrumentation of Data ...............................................................................................54
Validity ........................................................................................................................55
Reliability.....................................................................................................................55
Data Collection Procedures..........................................................................................56
Data Analysis Procedures ............................................................................................57
Ethical Considerations .................................................................................................59
Limitations ...................................................................................................................59
Summary ......................................................................................................................60
Chapter 4: Data Analysis and Results ................................................................................62
Introduction ..................................................................................................................62
Descriptive Data...........................................................................................................64
Data Analysis Procedures ............................................................................................65
Results ..........................................................................................................................74
Summary ......................................................................................................................75
Chapter 5: Summary, Conclusions, and Recommendations ..............................................76
Introduction ..................................................................................................................76
Summary of the Project ...............................................................................................77
Summary of Findings and Conclusion .........................................................................78
Implications..................................................................................................................80
Theoretical implications.................................................................................83
Practical implications. ....................................................................................83
Future implications. .......................................................................................84
Recommendations ........................................................................................................85

x
Recommendations for future projects. ...........................................................86
Recommendations for practice. .....................................................................87
Appendix A ........................................................................................................................95

xi
List of Tables
Table 1. Showing demographic characteristics of participants ........................................ 64
Table 2. Showing number of patient falls per week in the Surgical/oncology and the
Progressive care units ....................................................................................................... 65
Table 3. Showing descriptive information of the causes of falls and the possible solutions
to falls in the progressive and the Surgical/oncology units .............................................. 67
Table 4. Summary statistics of the analysis of variables .................................................. 70
Table 5. Showing the Regression Analysis....................................................................... 71
Table 6. Showing the Correlation Analysis ...................................................................... 71
Table 7. Showing the Test-Statistics................................................................................. 72

xii
List of Figures
Figure 1. Comparison of patient falls in the Surgical/oncology and the Progressive care
units ................................................................................................................................... 67

1
Chapter 1: Introduction to the Project
Introduction
Patient falls in hospitals remain as one of the biggest issues facing the healthcare
sector. It leads to the patient incurring injuries, deaths, extended hospital stays, and
equally high medication costs (Chan, 2015). Although there are many interventions put in
place to help prevent patient falls, it remains one of the most challenging issues in the
healthcare sector, especially in the acute care environment. As such, finding the most
reliable and effective patient-falls prevention method is the key in enhancing the quality
of patient care and patient satisfaction.
This project focusses on identifying the challenges associated with the Telesitter
monitoring technology in preventing patient falls, as well as the possible solutions to
these challenges. The working mechanism of the Telesitter systems is closely related with
that of bed alarms and sensors, and the resultant effect of using the two systems is
expected to be the same, especially concerning their effectiveness (Shorr et al., 2013).
This exposes the Telesitter systems to the same challenges posed by the bed alarms. One
such instance is when the video observer in the Telesitter systems abruptly starts
conversation with a specific patient, which can cause panic and disturbance among
patients. This scenario can cause the Telesitter system to be associated with many
challenges that can enhance the rate of patient falls rather than help in preventing patient
falls (El-Khoury, Cassou, Charles, & Dargent-Molina, 2013). This project used six
categories to identify the possible causative agents of the falls. The main categories of
factors include the physical factors, environmental factors, psychological factors
(Delahoz & Labrador, 2014), video operator factors, Telesitter system factors, and the
caregiver factors.

2
In order to enhance the effectiveness of the Telesitter system in reducing patient
falls, this project found possible solutions to the identified challenges facing the
Telesitter. Apart from that, the use of the Fallarm equipment alongside the Telesitter
system is encouraged for the high fall-risk patients (Davis, Kutash & Whyte, 2017).
Delahoz & Labrador (2014) present the Fallarm equipment as a reliable tool that can help
in reducing falls. The tool has capability to detect the position of the patient and
consequently warn them whenever their position indicates that they have high fall risk.
The system issues a warning sound, as well as warning lights to indicate whether a
patient is in good position or is faced with high fall risk.
The Fallarm device is beneficial because it will help in detecting high fall risk
situations and alerts the patient as well as the caregivers. Fallarm is a small wearable
wrist device that can detect patient movements and positions, and warn the patient
whenever the fall-risk rises (Delahoz & Labrador, 2014). The device has mini speakers
where the patient can communicate with a caregiver: it also has a visual feedback
component: and tactile feedback component (Davis, Kutash & Whyte, 2017). The device
uses inertial sensor to detect the position and movements of the patient. The device warns
the patient of high fall-risk by flaring a light alert. The lighting system gives red, amber,
and green to indicate high fall risk, medium fall risk, and low fall risk respectively. The
device also has a tactile system that uses pager motor to tap the user consistently
whenever their fall risk levels rise (Davis, Kutash & Whyte, 2017). The system also
notifies the caregiver whenever a patient’s movements or position translates to high fall
risk. This enables the caregivers to attend to patients that need immediate attention, thus
helping to reduce falls.
Although studies have in the past focused on the benefits of the Telesitter

3
technology in preventing patient falls, no research study has yet ventured in finding out
the disadvantages of using this technology in the acute care environment (McCurley &
Pittman, 2014). In light of this, this project is unique and beneficial in the healthcare
sector because it helps to solve the problems facing with the Telesitter monitoring
systems, helping this phenomenal tool to further reduce the rate of falls when used as a
falls reduction intervention. According to Davis, Kutash & Whyte (2017), the use of
Telesitter monitoring systems as opposed to in-room sitters helped to reduce fall rate by
6%. Considering the technological advantage of Telesitters, this reduction rate is small
and there is need to address the possible challenges associated with the tool to ensure that
it has higher capability of reducing falls significantly. Addressing these challenges, as
well as combining with the use of Fallarm devices among the high fall risk patients is
deemed to offer a better solution to the challenge of patient falls in the healthcare sector
(Delahoz & Labrador, 2014).
This project used the surgical/oncology and the progressive care units at the
Southern California hospital as the main source of participants. Although the Telesitter
systems are currently being used in these units to monitor patients, there is still high rate
of falls. This project is set to find out the challenges leading to the falls and the solutions
as outlined in the various falls incident reports.
Background of the Project
Patient falls, especially in the acute care environment, have been a long time
problem in the healthcare sector. Although many solutions have been adopted to prevent
patient falls, the incidence of patient falls across the United States has remained
alarmingly high. Currently, at least 700,000 to 1 million patients exhibit falls in the
healthcare environment each year (AvaSys, 2014). Among those who experience falls, at

4
least 30% and above exhibit serious injuries that result in extended hospital stay or even
death due to head injuries (Pearson & Coburn, 2011). On average, each single patient fall
costs the healthcare system and the patients an extra $14,000 (AvaSys, 2014). In 2008,
the Centers for Medicare & Medicaid Services classified patient falls as a hospitalacquired condition and withdrew compensation for the complications that ensued
(AvaSys, 2014). Considering that the costs associated with patient falls are not payable
by Medicaid and other third party payers, it is important that better patient fall prevention
strategies be implemented to help in reducing the additional falls-related cost burden on
healthcare institutions.
A new milestone in the healthcare sector occurred in 2008 when the AvaSure
Corporation developed the AvaSys Telesitter systems as a technological solution to the
problem of patient falls (AvaSure Holdings, 2015). Although this system is effective, it
does not offer the best solution to the issue of patient falls. The main challenge of this
technological tool is its impromptu mode of operation where the video controller or a
patient abruptly initiates communication through the device. This is mainly associated
with disturbances to the other patients in the ward, who require calm environments to
enhance their rest. The impromptu blaring of sound from the video operator through the
system or from a patient to the video operator can cause disturbance to resting patients,
which can then induce panic, anxiety, and fear among patients, leading to more falls. To
the nurses, the impromptu mode of operation of the Telesitter systems can cause panic,
anxiety, and nervousness among nurses, which can lead to more accidents and errors. The
reliance on calls from the video operator can also lead to non-observance of the other
patients. This is because the nurses rely more on the video operator, which can derail
their attention from the other patients who do not show physical signs of suffering and

5
pain. Reliance on the video operators is also not an effective approach because the mode
of operation of the Telesitter systems would fail when the video operator falls asleep or is
not attentive in monitoring the patients. This challenge gives chance to the idea of
combining Telesitter systems with Fallarm devices (Delahoz & Labrador, 2014). This
project also set out to find possible solutions to all other challenges associated with using
the Telesitter systems as a falls reduction tool.
Problem Statement
The main problem of focus for this project is the continued incidence of patient
falls even after the implementation of the Telesitter monitoring systems as a falls
reduction strategy. This project is set to find the factors leading to falls despite the use of
the Telesitter systems in wards. The project also ventured into finding the possible
solutions to the challenges associated with using Telesitter systems as a falls reduction
strategy. Telesitter systems are a technological tool, and one that offers better prospects
to the clinical sector when focusing on patient monitoring and surveillance. The system
was specifically designed as a falls prevention system, but has fallen below expectations
in the recent years since patient falls are still on the rise (CDC, n.d.). Finding and
addressing the challenges associated with the Telesitter systems is vital in enhancing the
fight against patient falls.
The population affected by the problem of falls is predominantly elderly
individuals aged 65 and over, but even younger individuals can develop healthcare
complications that need surgery and chemotherapy and can be equally be affected by
falls. This project is targeting to identify the factors leading to falls in the
surgical/oncology unit and the progressive care unit at Southern California hospital. The
categorization and prioritization of these factors in regard to their manifestation guided

6
the DNP student to select the best solutions. Implementing these solutions is deemed the
best possible intervention in ensuring that the Telesitter is an effective tool in reducing
the rate of patient falls.
This project contributes to the literature by outlining the challenges associated
with the Telesitter systems, and equally offering possible lasting solutions to these
challenges. It is not known whether the use of the Telesitter system could be causing
panic, anxiety, and fear among patients and caregivers, which could lead to more falls,
accidents, and errors in the healthcare environment. This is because the system works
using observation, which has the assumption that patients that appear to be still and
relaxed during observation are doing fine, but this assumption might be wrong in most
cases. There is need to find out if the use of the Telesitter system decreases caregivers’
vigilance and alertness in providing care to patients. Identifying the challenges associated
with the Telesitter system when used as a falls reduction tool helped to suggest corrective
measures. There is also an importance to investigate if the Telesitter systems are a
contributory factor to some of the falls. These factors were measured through evaluation
of participants’ perception about the challenges associated with the Telesitter. The
Telesitter system is particularly of focus because it is technological, but its mode of
operation is similar to that of bed alarms and sensors, which in the past have been
associated with many challenges to both the patients, as well as the caregiver. As such,
the project helped in identifying the most effective solutions to the challenges associated
with Telesitter systems, and thus improve its effectiveness in preventing patient falls.
Purpose of the Project
The purpose of this quantitative exploratory-descriptive project is to identify the
challenges associated with using the Telesitter monitoring systems in the clinical

7
environment, as well as finding lasting solutions to these challenges to ensure that the
Telesitter system is a reliable tool in the reduction of patient falls. This project assessed
and evaluated the causes of patient falls in the two wards – surgical/oncology and the
progressive care units, at a southern California hospital. Using the two units helped to
identify the most recurrent fall risk factors in these wards. This offered a more
comprehensive list of the factors leading to falls despite the use of the Telesitter systems.
Identifying the factors causing falls in the two units helped to identify the most-recurring
factors, which pointed out the best possible solutions to these challenges.
This project is set to determine the effectiveness of the Telesitter systems in
preventing patient falls, as well as the possible challenges facing this falls-prevention
intervention. The findings from this project guided in understanding the challenges
associated with the Telesitter systems and how best these challenges can be addressed to
ensure that it is a more effective tool in reducing patient falls. The Telesitter system is a
phenomenal intervention in the fight against patient falls, ironing out its associated
challenges will present a more reliable and effective tool in reducing patient falls.
Clinical Question
The major clinical questions that guided this project include:
Question 1: What are the challenges associated with using the Telesitter monitoring
system as a falls reduction intervention?
Question 2: What possible solutions can be implemented to solve these challenges and
make the Telesitter systems more reliable and effective as a falls reduction tool?
The first clinical question helped in understanding the challenges associated with
the Telesitter monitoring systems whereas the second question helped in understanding
how these challenges can be avoided. Evaluating the rate of patient falls in the two units

8
helped in identifying the most pertinent risk factors in reducing falls. Assessing both units
also shed light on how best the patients in the two units can be safeguarded to reduce
falls. This is considering the patients in the two units have different patient
characteristics, but are both highly affected by falls.
The clinical PICOT elements that guided this project include:
•

Population – Nurses giving care to patients in the surgical/oncology unit and
Progressive care unit at Southern California hospital.

•

Intervention – Using the Telesitter monitoring systems as a falls reduction
intervention.

•

Comparison – the factors influencing falls in the two units. The identified solutions to
the fall factors in the two units.

•

Outcome – reduced falls

•

Timeline – Over a period of one month
The DNP student was interested in finding out how the causes of falls in the two

units compare. The main difference between the surgical/oncology unit and the
progressive care unit is that the surgical unit is mainly associated with patients that have
undergone surgery, who usually have high fall risk. On the other hand, patients with
acute illnesses that require long-term observation and monitoring characterize the
progressive care unit. These patients too are at high risk of falling while in the clinical
environment.
Comparing the fall rate in the two units helped in understanding which factors
among patients and the clinical environment are more affiliated with increasing the risk
of falling. The incident reports helped in gathering the factors causing falls together with
the suggested solutions to these problems. Understanding the most prevalent factors in

9
causing falls and the best solutions to the factors from literature helped in settling on the
best possible solutions to patients exhibiting the identified challenges.
•

Dependent Variable: number of factors causing falls in their priority order in each
unit as guided by frequency of occurrence.

•

Independent Variable: Telesitter monitoring systems

Ho The Telesitter systems do not have challenges in reducing patient falls.
H1The Telesitter monitoring systems have numerous challenges in reducing patient
falls.
This project used falls incident reports to compile the factors leading to falls in the two
units. The incident reports also offered insight to the possible solutions to the identified
challenges. Combining the evidence from the literature review with the solutions offered
through the incident reports offered great solutions to the identified challenges.

Advancing Scientific Knowledge
This project advances knowledge because it identifies the challenges associated
with the Telesitter systems and their possible solutions, thus enhancing the effectiveness
of this tool in reducing the rate of falls. Improving the effectiveness of the Telesitter
systems is important because it a patient surveillance technology that enables for caring
for many patients at the same time. There are many benefits associated with the use of the
Telesitter systems, which makes it a vital tool in the healthcare delivery process. One
benefit is that it relieves nurses the burden of worrying about the high risk patients, which
helps to reduce burnout and work related stress (McLean et al., 2013).
This project also advances knowledge by emphasizing that there is need to have
other technological tools that can be used together with the Telesitter systems to enhance

10
their effectiveness as a falls reduction tool. This project also puts forward that although
the Telesitter systems are a good tool in the healthcare sector, there is need to continue
using more caregivers in the care delivery process. This standpoint is guided by two
major theories – Newman’s theory of health as expanding consciousness and the
Nightingale’s environment theory of nursing (Newman, 1994; Nightingale, 1860).
Newman’s theory of health as expanding consciousness states that health and sickness,
the two opposite conditions of concern in the healthcare delivery process – sickness and
health, are interrelated (Newman, 1994). Patients exhibit body stressors, pain, suffering,
and other adverse body reactions and require close interaction with healthy people to
instill health into them through emotional, physical, cognitive interaction. Keeping the
senses and body parts of the patient engaged and active can help a great deal in
alleviating pain, suffering, and restore health (Newman, 1994). On the other hand, the
Nightingale’s environment theory of nursing states that the patient’s environment is an
important factor in the healing process (Nightingale, 1860). This is because the patient
interacts actively and continuously with the environment and thus interacting with
cleaner, more beautiful and appealing environments could enhance comfort, which can
reduce falls. Close supervision of patients is also critical in reducing the risks factors that
lead to falls (Meade, Bursell, & Ketelsen, 2006).
Significance of the Project
The findings of this project are expected to be transformative; changing the
strategies used in the healthcare sector to prevent patient falls. This project is also
significant because it offers new findings concerning the challenges associated with using
the Telesitter systems, as well as possible solutions to these challenges. Identifying and
addressing the challenges associated with the Telesitter systems will ultimately help in

11
improving the effectiveness of the system in reducing patient falls. This is significant in
the healthcare sector since it will help to save the $14,000 extra per patient that goes into
treating fall-related conditions and ailments (AvaSys, 2014).
The findings from this project will also foster and encourage the use of
Nightingale’s environmental theory of nursing and Newman’s nursing theory in nursing
care. This is because the theoretical principles of these theories can help to enhance the
patients’ environment, reduce psychological pressures on the patient, improve the
environment state in clinical environments, enhance healing, improve patient satisfaction,
and reduce medication costs (Masters, 2015). The major principles of the Nightingale’s
environmental theory of nursing include ensuring that patients have temperaturecontrolled environments with clean air; patients should have noiseless surroundings when
resting and get exposure to enough sunshine; patient environment should be clean; and
patient surrounding should be constructed appropriately (Nightingale, 1860). On the other
hand, Newman’s theory of health as expanding consciousness gives four main principles
for use in the healthcare sector (Newman, 1994). These principles include concept of
unitary human beings, human beings have a person-environment process and interaction,
every persons including patients are in the process of expanding their well-being and
consciousness, and consciousness is attained through information capacity of an
individual. From these principles, it is evident that these theories helped caregivers to
master and understand the patient-environment relations, and thus put in place the best
measures to help each patient avoid falls.
The findings from this project, coupled with the theoretical foundations used in
this project, the Nightingale’s environmental nursing theory and Newman’s nursing
theory, highlights that understanding and managing the patient environment effectively

12
can be invaluable in helping patients to relax and calm down their worries, which can
reduce falls (Nightingale, 1860; Newman, 1994). These theories also emphasize on the
need for more caregiver interaction with the patients. The theorists argue that constant
visitation and observation of patients can help to invoke the patient’s feelings, hopes,
senses, and consciousness, which helps the patient to feel more comfortable and relaxed.
This can help to reduce falls.
The findings from this project will help in improving the effectiveness of
Telesitter systems as a falls reduction intervention. The findings might also help in
combining the functionality of the Fallarm device and the Telesitter systems, helping to
advance the reliability of the Telesitter systems as a falls reduction tool. This project’s
findings will ultimately benefit patients since patients was exposed to reduced fall risks,
thus guaranteeing them better safety during their hospital stays. Safer hospital stay is a
core underpinning principle of the Nightingale’s environmental theory of nursing
(Nightingale, 1860). This project will also benefit the entire healthcare system because it
will reduce the costs associated with the side effects of falls.
Rationale for Methodology
The quantitative project methodology is the best fit for this project because it
offers analytical and numerical findings on the factors given by the falls incident reports.
The quantitative methodology is also preferred because it shows the frequency of the
occurrence of the factors leading to falls, helping to single out the most persistent factors
that need immediate attention. This project mainly uses falls incident reports as the main
form of data collection. Comparing the factors in the two intervention units helped to
highlight which factors are more relevant in either unit, as well as factors that cut across
the units. Identifying these factors guided in formulating possible solutions to improve

13
the effectiveness of the Telesitter systems. The solutions given on the incident report
were used in developing final recommendations and conclusions on how to solve the
challenges facing the Telesitter systems.
Nature of the Project Design
This project utilizes the exploratory-descriptive project design. This design entails
the use of data findings, especially opinionated findings to formulate a position and
essentially formulate a solution to the challenge. However, this design can also use
numerical data. In this case, it guided the collection of information regarding the possible
factors leading to falls when using the Telesitter systems as well as a list of the possible
solutions to the identified problems. This project uses falls incident reports to collect data
findings. Getting the factors related to falls in their priority order helped in addressing
them systematically, ensuring that the use of Telesitter systems has more reliability and
effectiveness in reducing falls.
The project sample population was nurses working in the surgical/oncology unit
and Progressive care unit at Southern California hospital. The patient population under
investigation is patients receiving care in the surgical/oncology unit and Progressive care
unit. The DNP student was interested in collecting the factors highlighted as causative
agents of patient falls, as well as the given solutions. Understanding the factors that
caused the falls guided the DNP student to formulate additional solutions to these
problems. It is expected that addressing these challenges and problems will help in
improving the effectiveness of the Telesitter monitoring systems in reducing the
prevalence of falls. The data collected from the falls incident reports from the two units
was assessed and analyzed using Statistical Package for the Social Sciences (SPSS)

14
software to give finer details as to which factors have more priority in reducing patient
falls. The analysis also showed how the factors in the two units are related.
Definition of Terms
The following terms were used throughout the project proposal.
•

Telesitter

A system designed with a 360 degrees video coverage of a room, a two-way audio
transmitting system, and a lockable wheel system used for observing patients and
controlled from a central operator room (Martin, 2015).
•

Patient-falls

The literal act of patients rolling over their beds and falling on the floor, or the act of
patient tripping when walking around the ward, and falling on the ground (Martin, 2015).
•

Caregiver

For this project, caregiver is a nurse or physician that takes care of patients in a ward
(Martin, 2015)
•

Impromptu patient calls

When a video operator initiates calls to the patients to inform them that they might fall or
giving instructions to help prevent falls (Martin, 2015).
•

Impromptu caregiver calls

When the video operator initiates calls to the caregiver, informing them that they need to
attend to patients urgently (Martin, 2015).
•

Elderly patients

For this project, elderly patients are any patients above the age of 65 years receiving care
in the ...