Camera over each pts bed on the M/S unit.

Good Morning, Gil · Mar 6, 2012

Jrwest, good point, but my point was that a camera is no more effective than a bed alarm. It can't increase your response time, so extra staff are needed, sitters and the like.

That's interesting, Juan. I can see my two patients at all times, and I'm glad for that. M/S nurses have it rough since half the time their highest risk for falls may be a mile away since that was the only bed available at the time. I worked in rehab, so I know how that can be.

jlog.j · Mar 6, 2012

I think its more for risk mgmt.

jlog.j · Mar 6, 2012

Exactly, and our nurses station is all open for everyone to see.

jlog.j · Mar 6, 2012

It won't help, it will let Admin. know who to blame and to fire when it happens. This is the cheap way to "keep pts safe", and like I've said before, admin. can say to ACHA "look we are so serious abt pt. safety we even installed these cameras".

Dazglue, ADN, BSN, MSN, RN · Mar 6, 2012

I wished we had cameras over the bed. Then maybe the "higher-uppers" will believe us when we tell them pt's are pulling off their fall alarms, or turning off their bed alarms because apparently, documenting and our words don't mean s***. Then they'll realize why having a patient load of 10 isn't safe...espesically when you have 7 bed-hoppers....and no working bed alarms.

Entropic · Mar 6, 2012

My father in law DID fall in the hospital 2 nights ago - now we are taking turns sitting up there with him. Am I the only one who thinks the family should have some role in care, especially when dealing with the elderly? No one can be everywhere at once.

I also have to say everyone has been WONDERFUL throughout this whole thing. I had the "overnight" shift with him last night, and his nurse brought me a blanket and some cranberry juice "because she saw me drinking some earlier and knew I liked it." I think she was just grateful for a little extra help. JMO.

Esme12, ASN, BSN, RN · Mar 6, 2012

Using monitoring devices is acceptable if it is done for legitimate reasons related to patient care and if patients or their legal representatives give permission for the monitoring. A good practice would be asking the patient or his or her legal representative to sign a consent form stating that the patient understands a visual monitoring device will be used in the room and he or she consents to its use.

Q&A: Cameras in patient rooms - www.hcpro.com

This is a tricky one...

If the patient room is private, and the patient has provided consent for the placement of the camera, then there is no HIPAA violation, though any videotaped footage can be "rescinded" by the patient at any time. The video it self like eraser marker boards is a part of HIPAA, is protected health information, and cannot be seen by the public. Any "taped" information is protected health information and is provided protection under HIPAA law.

The sign in your lobby is likely notification to the public that their images will be captured on security cameras in your hospital, such as near the exits or the OB unit. I would highly doubt it is intended to "cover" hidden cameras in patient rooms. Facilities would have to have explicit, signed permission from EACH patient to videotape in rooms. Turning cameras on and off as each patient dictates in order to "catch" a nurse in an inappropriate activity is highly unlikely, however, the facility can use cameras to discipline and observe nurses behavior.

Like any other patient information there will have to be policies and procedures as to the taping of patients, the handling/storing/preservation of these tapes will have to be decided. That would be a lot of resources to spend for little return...someone would have to constantly turn them on/off 24 hours a day...which is probably not likely to happen. In my experience, "hidden" cameras are most often placed at nurses stations and ESPECIALLY medication/treatment rooms where narcotic diversion or supply pilfering could occur.

The use of these tapes to discipline staff regarding patient rounds, generally you will be OK if you are following hospital policy. In a court of law, this should hold up just fine, unless the patient's condition warranted more frequent observation, i.e. hourly, based on prudent nursing judgement. If most other experienced nurses would check a patient more frequently than policy dictates, then the court could hold you to that same expectation. There has been documentation that the presence of cameras in the OR has decreased wrong site wrong patient, left surgical instrument/supplies, and a decrease of infection rates Due to strict compliance with policies.

AHRQ WebM&M: Morbidity & Mortality Rounds on the Web

That being said, if the request for more frequent monitoring is made by the family, the use of cameras could help maintain harmony on the unit by assuring families their loved one is being watched and possibly decrease litigation when physical/chemical restraints are used. However, Never, EVER, try to use policy as an alternative to nursing judgment. I can find no evidence that there has been a decrease in falls with the use of cameras. I will be curious as to their use in a court case and in discipline procedures

RNsRWe, ASN, RN · Mar 6, 2012

It actually sounds like they may be inviting litigation instead of avoiding it.

This thing is recording the actual amount of time it takes to get into the room and pick up patient, assess, etc. Without video, you have the nurse's notes: bed alarm sounded, immediately ran to patient's room and found him laying on floor, yada yada. WITH video, you have someone counting off the seconds (or, worse, minutes) before he's found on floor.

Unless the video monitoring person is also going to get up and run to that patient trying to hurl himself over the siderail, I don't see it as a better system. We were frequently so short-handed that just hearing a bed alarm didn't mean anyone could even get there fast enough, if the other other nurses were also wrestling demented patients and cleaning up poop, or physically distant (far end of unit, whatever).

FLmomof5 · Mar 6, 2012

The issue I have with this is that we, as nurses, are SOOOOOOO busy, there is no one at the nursing station to watch the cameras! Bed Alarms are more useful in that you hear them and get to the room ASAP. (BTW, I work nights.) I don't think it is an invasion of privacy IF the patient knows that they are there and can approve or deny their use. Just my .02!

RNsRWe, ASN, RN · Mar 6, 2012

I don't think it is an invasion of privacy IF the patient knows that they are there and can approve or deny their use. Just my .02!

The problem being, of course, that the vast majority of the ones needing sitters are not competent to approve or deny (totally demented climbers are coming predominantly from nursing homes, where they usually drop the patient and run like hell--good luck getting approval for something like that when there's no cameras in the nursing homes they come from!). You might be lucky enough to actually get ahold of a family member, but that's probably several hours or even days after Grandpa ripped out his IV, his Foley, and did the fish flop onto the floor.

Whispera, MSN, RN · Mar 6, 2012

A camera would catch the image when a patient falls but then it would be too late because the patient would have fallen! I can see a use to watch for getting up and trying to get out of bed, but that's what the movement monitors/alarms are for. It seems like a big expense (and someone has to watch what's projected so someone would have to be hired or someone already overworked would have to do something else!), an invasion of privacy, and the money could be used elsewhere.

If I was in the hospital and had a camera over my bed, I would NOT like it, whether I had fallen in the past or not. It would not make my ratings of the care that was given go up.

martymoose, BSN, RN · Mar 7, 2012

uggh you know, you guys are right- the cameras ARE probably being used Against us. Duh, what was I thinking. Forgot about the pre-requisite for management to throw under the bus every nurse that they possible can.