Date of Award
Summer 7-17-2026
Document Type
Scholarly Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
David Liguori, DNP, APRN, NP-C
Second Advisor
Terrance Thompson DNP, RN
Abstract
Practice Problem: Patient falls remain a significant patient safety concern among hospitalized adults, particularly those at high risk. Traditional fall-prevention strategies, including continuous 1:1 sitter observation, require evaluation to determine their effectiveness in reducing falls and fall-related injuries.
PICOT: In hospitalized adult patients at high risk for falls (P), does continuous 1:1 sitter observation (I), compared to standard safety interventions (C), reduce fall rates (O) as measured by reported falls per 1,000 patient days during hospitalization over 12 weeks (T)?
Evidence: Current evidence supports multifactorial fall-prevention programs that combine patient assessment, staff engagement, and proactive nursing interventions through intentional rounding. Although continuous sitter observation may improve patient monitoring, evidence suggests that observation alone may be insufficient for cognitively impaired patients who are unable to consistently follow safety instructions.
Intervention: A 12-week quality improvement project implemented continuous 1:1 sitter observation for adult patients identified as high risk for falls on a medical-surgical unit. Staff education, ongoing monitoring, incident reporting, and pre- and post-implementation staff surveys were used to evaluate intervention implementation and outcomes.
Outcome: Although the intervention did not achieve the targeted 30% reduction in falls and the overall fall rate increased during the implementation period, no falls with injury were reported. These findings suggest that continuous 1:1 sitter observation may have reduced the severity of fall-related harm but did not reduce the overall frequency of falls.
Conclusion: Continuous 1:1 sitter observation alone was insufficient to consistently reduce falls among high-risk hospitalized adults. The findings support the use of multifactorial, evidence-based fall-prevention strategies, including intentional rounding and individualized interventions, to improve patient safety and reduce fall-related harm in acute care settings.
Recommended Citation
Williams, Z. (2026). Continuous 1:1 Sitter Observation Versus Standard Safety Interventions to Reduce Falls in Hospitalized Adults at Risk. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.DHKG8706
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Included in
Environmental Education Commons, Environmental Monitoring Commons, Occupational and Environmental Health Nursing Commons, Primary Care Commons
Comments
Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.