Date of Graduation

Winter 12-16-2016

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions



First Advisor

Dr. Marjorie Barter, EdD, RN, CNL, CENP

Second Advisor

Fr. Timothy Godfrey, SJ, DNP, RN, PHCNS-BC


The financial constraints imposed upon operational budgets by the frequent use of patient care sitters is well known among hospital leadership. Despite the high labor costs associated with direct and continuous observation, this intervention is routinely deployed by frontline care teams in an effort to preserve patients from harm, particularly from accidental falls. This reality creates an opportunity where significant budget savings can be achieved by supplanting the use of patient care sitters with more effective fall prevention strategies. This quality improvement (QI) project implemented a non-psychiatric sitter reduction and fall prevention initiative in two high volume adult acute care units. Through a collaborative process involving frontline staff, clinical subject matter experts, leadership stakeholders, and medical equipment vendor support, this project implemented a three-fold quality improvement effort including education, policy enhancement, and patient safety supply evaluation. This multi-tier engagement included a 60-day clinical evaluation of the program elements where sitter utilization, fall events, and falls with injury were compared to the organization’s historical performance. The project produced a 46% reduction in sitter utilization within the two trial units. Though fall outcomes were unaffected by this QI project, the initiative produced results commensurate with contemporary evidence that utilization of patient care sitters can be effectively reduced without risk to patient safety.