In our "Sitter Usage" webinar, you can expect to learn about the challenges of providing a patient with a sitter and the labor costs associated with it. Nash Analytics™ has the capability to monitor how often PCTs, RNs and other support staff are pulled out of staffing to sit with a patient. We’ll use this webinar to show how to: -Track sitter usage -Review reports that track hours and cost -Identify units that can benefit from alternative sitter options -Determine when it when its best to “hard wire” sitters into the budget -Review alternatives to sitters as outlined in a Medscape article.

1. change innovation & analytics
Sitter usage webinar

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Housekeeping
 Download today’s PowerPoint presentation
from our website www.nashgroup.com
 We’ll take questions during the last 10‐15
minutes
 We’d like your feedback

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Today’s objectives
 Quantify sitter usage
 Real time monitoring of sitter usage
 Determine when it is best to “hard‐wire”
sitters into the budget
 Review alternatives to sitters as outlined in
this Medscape article
http://www.medscape.com/viewarticle/806798_3

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Required metrics
Capture all care givers including care givers
pulled out of staffing
Track by care giver type or job class code
Calculate the FTEs, hours and cost of sitter
consumption
Track patient types

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Patient types
 The main reason cited for use of sitters is
prevention of patient falls
 Patients with specific symptoms or conditions
⁻ Confusion, disorientation, or delirium
⁻ Hallucinations, agitation, psychosis
⁻ Physical aggression
⁻ Suicidal ideation
⁻ Risk for removal of lines, catheters, devices, or
equipment
 Physician’s and/or family request

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Midwest case study

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Emory sitter experience
 Clinical Staffing Resources Center (CSRC).
⁻ Multidisciplinary team to evaluate the issue
 Most frequent indications for sitter use were identified
 Goal was set to reduce sitter use by 50% across the health care
system in 1 fiscal year without significant negative impact on quality.
 Baseline data obtained and preliminary questions answered. "Why do
we use sitters, what was the cost, and were sitters the most efficient
way to use staff?“
 Equipment, education, rounding, culture change
 Goal to reduce sitter use by 50% in 1 fiscal year without negative
impact on quality was achieved
 http://www.medscape.com/viewarticle/806798_5

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6 months post implementation

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Agency sitter costs

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Track usage and share with staff
 The most difficult challenge associated with
this practice change was shifting the
mindset of the nursing staff. Ordering a
sitter for any patient situation out of the
ordinary was no longer an option. Staff
were surprised to learn that presence of a
sitter did not necessarily translate into a
decrease in falls or other quality metrics.
Rather, it was the intentional presence of
the nursing staff that was pivotal to the
successful reduction in sitter use.

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Hours detail report

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Cost detail report

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Alternative sitter options
 Move room close to desk
 Hourly rounding/toileting schedule
 Identify patients at risk for fall in shift safety
huddles
 Identify environmental concerns
 Bed alarms, bedside commode sensors, chair
alarms
 Activity aprons
 Nonskid socks and floor mats
 Arm bands, chart stickers, color coded blanket