Claire Dawson
In a hospital setting, the term watch can refer to two different things. One is a patient watch or patient watch program, which involves a security officer or qualified staff member monitoring a patient who may be a danger to themselves or others. This can be done in person or through the use of video monitors. The other meaning of watch in a hospital context refers to timepieces worn by medical professionals, such as wristwatches, fob watches, or smartwatches like the Apple Watch. These watches can be used to track time, record clinical assessments, and stay connected with notifications.
Characteristics and Values of a "Watch" at the Hospital
| Characteristics | Values |
|---|---|
| Patient Watch | A program to provide close watch over a potentially dangerous patient, or a patient with dementia, mental health or substance abuse problems who may become combative or suicidal. |
| Patient Watch Staff | Trained staff who monitor patients in person or via video surveillance. |
| Sitter Program | A healthcare attendant assigned to watch over a patient who is elderly, disabled, or otherwise impaired. |
| Watch Lists | Databases of names, titles, and other information used to identify unwanted visitors and alert security. |
| Time-Keeping | Wristwatches, wall clocks, mobile phones, and tablet computers are used for time-keeping and recording temporal data. |
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Patient watch programs
Hospitals often struggle with the need to closely monitor potentially dangerous patients without relying on skilled nurses or security officers who are needed elsewhere. A patient watch program is a solution to this problem.
A patient watch program is not the same as a sitter program, in which a healthcare attendant is assigned to watch over a patient who is elderly, disabled, or otherwise impaired. While a sitter program is effective for patients who may be at risk of falling or other nonviolent risks, it is not appropriate for potentially dangerous patients. A patient watch program, on the other hand, involves a security officer posted with a patient to protect that patient and others.
Under certain conditions, such as when a patient is suicidal, there must be a one-on-one patient watch with a qualified staff member monitoring the patient at all times. In other situations, it is permissible for a staff member to watch more than one non-committed patient, as long as additional staff are available to respond in an emergency. Hospitals can schedule trained patient watch staff for high-probability times like weekends, and have other staff on call for times when such patients are less likely to appear.
Video monitors can also be used in patient watch programs. A staff member can monitor several non-committed patients simultaneously through video, as long as they are constantly monitoring only those patients and there is another staff member who can respond immediately if something happens. Many hospitals are developing seclusion rooms that are grouped together, making it more feasible for a single staff member to monitor several patients at once.
Patient watch officers receive intensive and specialized training and are available 24/7. They do nothing else but watch the patient, and if the situation escalates, the officer is there to attempt to de-escalate it.
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Sitter programs
Hospital sitter programs provide patients with one-on-one supervision and companionship to enhance their recovery process. Sitters are trained to observe and assist patients who may be at risk of harming themselves or others, or experiencing confusion or agitation. They work closely with the nursing staff to ensure the patient's safety and comfort. Sitters are not medical professionals and cannot administer medication or perform medical procedures. However, they can provide basic assistance with tasks such as eating, drinking, using the bathroom, or moving around the room. They also monitor the patient's vital signs, such as blood pressure, heart rate, and temperature, and keep records of the patient's behaviour, any assistance provided, and any changes in their condition.
Hospital sitter programs offer several benefits to both patients and the hospital staff. For patients, sitters provide emotional support and companionship, which can help alleviate feelings of loneliness, anxiety, or distress. They also create a safe and comfortable environment, fostering a positive patient experience. Sitters are often able to spend more time with patients than clinical staff, allowing them to provide unique insights into the patient's condition and progress, which can enhance the overall quality of care.
For hospital staff, sitter programs can free up time and resources. Without a dedicated sitter program, nurses and other clinical staff may need to take on additional patient-sitting responsibilities, disrupting their normal duties and straining their operations. Employing a team of well-trained sitters can optimize the hospital's resources and enhance patient safety and satisfaction.
Additionally, hospital sitter programs can be customized to meet the specific needs of patients. Sitters can work with patients who require constant observation or those who only need occasional check-ins. They can also be trained to perform environmental services and patient transport tasks, further reducing overhead labor costs and streamlining hospitality services.
Overall, hospital sitter programs provide valuable support to patients and hospital staff, contributing to a positive and efficient healthcare environment.
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Video monitoring
To protect patient privacy and comply with regulations, hospitals must ensure that video recordings are not stored on cameras or remote servers. Systems like the Wisenet WAVE video management system (VMS) provide a non-recording option for hospitals. The selection of the right VMS can also improve a hospital's return on investment (ROI) by reducing costs associated with patient falls and improving efficiency in staff utilisation.
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Watch lists
There are several types of watch lists used by hospitals. One common type is a sex offender watch list, which helps ensure that registered sex offenders are not allowed to access areas in the hospital frequented by children. Former employee watch lists are also used to identify former employees who may return to the hospital with bad intentions, such as harming a former supervisor. Hospitals may also use estranged family member watch lists, where ex-spouses or estranged family members are added to provide peace of mind for patients.
In addition to these watch lists, hospitals may also implement patient watch programs. These programs involve assigning a security officer or patient watch officer to sit with a patient who may be potentially dangerous, combative, or at risk of suicide, to protect them and others. This is different from a sitter program, where a healthcare attendant is assigned to a patient who is elderly or disabled and at risk of falling or other non-violent risks. Patient watch programs aim to provide close monitoring and de-escalation of potentially high-risk situations.
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Wristwatches
Wearing wristwatches in hospitals is a debated topic, with some hospitals banning them due to the risk of pathogen transfer. The National Institute for Health and Care Excellence (NICE) has inadequate evidence to support its guidance on this issue. The bare-below-the-elbows (BBE) policy, which aims to improve handwashing practices by reducing potential pathogens on jewellery, watches, and long sleeves, is practicable in hospitals. However, in out-of-hospital settings, it poses challenges for emergency care workers who need to record temporal data accurately.
Some doctors and nurses opt for washable watches like the G-Shock for procedure days and shifts expecting a lot of nursing messages, respectively. Others prefer the Apple Watch for its versatility, activity tracking, and ease of cleaning. Some also use smartwatches for remote hospital login and prescribing narcotics.
The presence of bacteria on the hands of watch wearers compared to non-wearers is a concern. Fagernes and Lingaas (2011) found that watch wearers had three times more bacteria on their hands than non-wearers. Additionally, factors like cracked screens, use of phone cases, and irregular cleaning increase the risk of pathogenic bacteria on phones, which may substitute for wristwatches.
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Frequently asked questions
A patient watch program is a way for hospitals to provide close observation of potentially dangerous patients without relying on skilled nurses or security officers. Patient watch officers are not caregivers, but they are responsible for de-escalating situations and protecting the patient and others.
A patient watch program is necessary when a patient is a danger to themselves or others, such as when a patient is suicidal or has substance abuse problems. In these cases, a one-on-one watch is required, with a qualified staff member monitoring the patient at all times.
Alternatives to a patient watch program include sitter programs, where a healthcare attendant is assigned to a patient who is elderly, disabled, or otherwise impaired. Additionally, video monitors can be used if a staff member is constantly monitoring a single patient.
It is generally recommended to avoid wearing watches and jewellery in medical environments due to hygiene concerns. However, some watches are designed to be resistant to magnetism and easy to clean, making them suitable for hospital use. Examples include watches from brands like Casio, Seiko, Citizen, and G-Shock.
