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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 who have access to ligature or other safety risks, constant 1:1 visual observation must 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, unless as described below.

For patients at high risk for suicide, video monitoring may 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 must 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, when needed, by the qualified staff member assigned to observe the high-risk patient. 

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
Manual: Hospital and Hospital Clinics
Chapter: National Patient Safety Goals NPSG
Last reviewed by Standards Interpretation: February 01, 2022 Represents the most recent date that the FAQ was reviewed (e.g. annual review).
First published date: March 07, 2019 This Standards FAQ was first published on this date.
This page was last updated on January 29, 2024 with update notes of: Editorial changes only Types of changes and an explanation of change type: Editorial changes only: Format changes only. No changes to content. | Review only, FAQ is current: Periodic review completed, no changes to content. | Reflects new or updated requirements: Changes represent new or revised requirements.
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