Date of Award


Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chair

Ann L. Bianchi

Committee Member

Ellen Ahlersmeyer


Falls (Accidents)--Prevention, Hospital patients--Safety measures, Video surveillance


While several improvements continue in hospitals involving fall prevention, falls and falls with injury continue to occur all too frequently in hospitals, particularly in elderly patients. This Doctor of Nursing project is the implementation of a virtual sitter program (VS) on a medical-surgical unit at a community hospital in northeast Indiana. The patient population for this project includes patients admitted to a medical-surgical unit that are male or female patients over the age of 18 with a history of falls and are considered at high risk for falls. This is an evidence-based new program implementation project with the aim of decreasing falls, falls with injury and the cost of one-one-one (one-to-one) in person bedside sitters. A literature examination supported the positive outcome of implementing a VS to decrease fall and cost. Evaluation of the project includes pre-implementation data regarding falls, falls with injury and cost of one-to-one sitters 6 months pre and 3 months post implementation. Summary of results showed no falls or falls with injuries among any patients who had either a one-to-one or VS post-implementation. The falls per 1000-person days were higher pre-implementation (number of falls = 8) than post-implementation (number of falls = 6) with a fall rate of µ 5.77 and µ 4.17, respectively. A net decrease of 16% in falls post-implementation was shown as compared to pre-implementation. Moreover, while there was one fall with injury pre-implementation in patients who did not have a sitter, the falls per 1000-person days were higher pre-implementation than post-implementation µ 0.67 and 0, respectively. Lastly, the number of hours spent on sitting increased to 2,239 (one-to-oner = 576, VS = 1669) from 629 pre-implementation; however, given the lower total cost associated with VS pre- and -post implementation, there was a net decrease in cost of $12,097 dollars from pre-implementation to post- implementation (one-to-one = $15,630 VS = $3,533.00) for sitters. Additionally, there was also a decrease of $9,978 dollars during the post-implementation analysis (one-to-one = $13,511 VS = $3,533) of sitter use.

Available for download on Saturday, February 08, 2025