1. Burtson, Paige MSN, RN, NEA-BC
  2. Vento, Laura MSN, RN, CNL

Article Content

To the Editor:


Thank you for the opportunity to respond to the letter to the editor regarding the recent article we wrote, "Sitter Reduction through Mobile Video Monitoring" (JONA; July/August 2015; 45 (7/8):363-367). We very much appreciate Dr Jurchak's well-articulated point that patients' experience of a new technology should be thoughtfully planned for and evaluated. In our case, we did not collect objective patient experience metrics specific to the monitored patients that could be benchmarked and reported. As a result, this aspect of the video monitoring program was not specifically addressed in the article.


We can report here aspects of the program design that addressed the need for patients to feel cared for that were not outlined in the article. To personalize the experience for patients, we do have the Video Monitor Techs (VMTs) round on each monitored patient in the first 30 minutes of the shift to introduce themselves in person. The VMTs quickly learn what works best for each patient and are able to personalize their interventions to meet the patient's unique needs. One patient, on a grave disability hold, was in an air-borne isolation room with no family or friends to visit her. Noting this, in their downtime, the VMTs would initiate conversations with the patient over the 2-way audio to continue the connectedness. If a patient becomes agitated from verbal redirection, the VMTs immediately contact the staff to intervene versus using the 2-way audio feature. We have modified the location of the video monitor to outside the door for some patients. An example is a patient who is gravely disabled because of a psychiatric diagnosis or has a conservator and poses a risk of elopement, but objects to being monitored in the room and poses no harm to himself.


The evaluation of the program from the patients' perspective has been completed through unstructured patient interviews. Subjectively, we can report that the technology overall has been well received by patients and families, especially in regard to the 2-way audio communication that provides patients an additional resource to contact staff and address a safety concern. In interviewing older adults who might require video monitoring because of risk of falling due to generalized weakness and failure to use the call light for assistance, we have observed that some patients object to the term "high fall risk" as it threatens their sense of independence. One older adult female patient argued that she was not at risk of falling, but when asked what her understanding was for the video monitor in her room, she responded, "Oh, that is just an additional helper who reminds me of a few things when I forget." Her perspective is interesting especially in light of the increasing number of older adults we are caring for. It may be that video monitoring could be perceived as less of a threat to patients' independence compared with a 24/7 sitter.


We do agree that it would be an interesting follow-up study to qualitatively analyze the patient experience of video monitoring technology compared with sitters to better understand its impact on patients in all of its depth and complexity.


Paige Burtson,MSN, RN, NEA-BC


Associate Nursing Director


UC San Diego Health System




Laura Vento,MSN, RN, CNL


Nurse Manager


Medical-Surgical Specialties


UC San Diego Health System