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Ligature and/or Suicide Risk Reduction – Video Monitoring of Patients at High Risk for Suicide

Can video monitoring/electronic-sitters be used to monitor patients at high risk for suicide?

Any examples are for illustrative purposes only.

For patients identified as high risk for suicide, constant 1:1 visual observation should be implemented (in which a qualified staff member is assigned to observe only one patient at all times) that would allow the staff member to immediately intervene should the patient attempt self-harm.  The use of video monitoring or “electronic sitters” would generally not be acceptable in this situation because staff would not be immediately available to intervene. The use of video monitoring would be acceptable as a compliment to the 1:1 monitoring, but not acceptable as a stand-alone intervention.

For patients at high risk for suicide, video monitoring should only be used in place of direct line-of-sight monitoring when it is unsafe for a staff member to be physically located in the patient’s room.  In addition, for both direct line-of-sight and video monitoring of patients at high risk for suicide, the monitoring should be constant 1:1 (at all times, including while the patient sleeps, toilets, bathes, etc.) and the monitoring must be linked to the provision of immediate intervention by a qualified staff member when required.

The use of “electronic-sitters” or video monitoring for patients who are NOT at high risk for suicide is up to the discretion of the organization. There are currently no leading practices on how to use video monitoring to monitor those at risk for suicide.  It is important to reassess patients who are at risk for suicide, despite the monitoring method that is chosen.

Additional Resource:
Suicide Prevention Portal
Last updated on March 03, 2021
Manual: Critical Access Hospital
Chapter: National Patient Safety Goals NPSG

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