Date of Graduation

Fall 12-11-2020

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Executive Leader DNP

First Advisor

Dr. Juli Maxworthy

Second Advisor

Dr. Elena Capella


The setting for this DNP project was a 326-bed, suburban hospital in Northern California that was facing challenges with preventing falls with injury and rising sitter costs. Between May 2018 and June 2019, there were four sentinel events related to falls with significant injuries. This hospital was financially impacted by the growing cost of the expanding sitter program caused by the rising elderly patient population, with demographics requiring one-to-one, in-person sitters to observe them visually. There is ample research demonstrating the utility of video monitoring systems to improve patient safety by reducing falls, enhancing staff safety by reducing workplace injuries caused by agitated patients, and decreasing hospital costs by reducing sitter hours. This program provides a virtual sitter with the ability to redirect the patient verbally and summon assistance in real-time to prevent patient harm.

By September 1, 2020, the aim was to develop, implement, and evaluate a virtual sitter pilot program, reduce patient falls by 20%, reduce workplace injury claims by 20%, and reduce sitter costs by 15%. Objectives included developing an implementation playbook, identifying a video monitoring technology solution, and piloting a virtual sitter program. Preliminary results show that the fall rates were statistically significant for improvement during the pilot intervention. There was an increase in the number of patients who received a virtual sitter while total sitter hours showed a statistically significant decrease, and there was no impact on the sitter HPPD. The estimated return on investment (ROI) for the pilot hospital was projected to be $415,883 for the first year of implementation.

Included in

Nursing Commons