We describe the patient experience with remote video monitoring on a general practice inpatient floor in the hospital. We raise questions about unexplored areas relevant to this practice

Angell, Daniel, DO

Athar, Aysha, DO

Brewis, Jonathon, MD

Shoemaker, Eric, MD

Zaban, Rana, DO

English

Digital Commons@Wayne State University

Clinical Research in Practice: The Journalof Team HippocratesVolume 4 | Issue 1 Article 102018Letter to the Editor: Patient and Staff Experienceswith Inpatient Video MonitoringEric Shoemaker MDAnnapolis Family Medicine Residency, Beaumont Wayne Hospital, eric.shoemaker@beaumont.orgAysha Athar DOAnnapolis Family Medicine Residency, Beaumont Wayne Hospital, aysha.athar@beaumont.orgJonathon Brewis MDSt. John Hospital Emergency Medicine Residency, jbrewis7@gmail.comDaniel Angell DOAnnapolis Family Medicine Residency, Beaumont Wayne Hospital, angelldc@gmail.comRana Zaban DOAnnapolis Family Medicine Residency, Beaumont Wayne Hospital, rana.zaban@beaumont.orgFollow this and additional works at: https://digitalcommons.wayne.edu/crpPart of the Medical Education Commons, Nursing Administration Commons, TelemedicineCommons, and the Translational Medical Research CommonsThis Letter to the Editor is brought to you for free and open access by the Open Access Journals at DigitalCommons@WayneState. It has been acceptedfor inclusion in Clinical Research in Practice: The Journal of Team Hippocrates by an authorized editor of DigitalCommons@WayneState.Recommended CitationSHOEMAKER E, ATHAR A, BREWIS J, ANGELL D, ZABAN R. Letter to the editor: Patient and staff experiences with inpatientvideo monitoring. Clin. Res. Prac. 2018;4(1):eP1711. doi: 10.22237/crp/1528502520Patient and Staff Experiences with Inpatient Video Monitoring     We read your article ‘Remote video monitoring is another example of “dying on the machine” for critically ill patients’ with interest.1   In this age of digital social networks, many of our daily interactions are no longer face-to-face, and social interactions are changing in ways that we don’t yet understand. Medicine has always valued compassion and a “healing touch.” As these new digital technologies change patient interactions, it is still unclear how they affect patient care.  Uchino, Uchino et. al., and Cohen review pathophysiological explanations that mediate the relationship between social support and disease outcome or death.2-4 Controlled studies on morbidity and mortality related to video monitoring have not been done. In spite of this, remote video monitoring is regularly employed in the inpatient setting at our hospital.    Our inpatient medicine team recently cared for a patient who was delirious due to alcohol withdrawal. He fell out of his hospital bed despite being monitored remotely with video surveillance. Our patient did not sustain any significant injury, but we used this event as an opportunity to explore patient and staff experiences with video monitoring.   Our patient shared his thoughts on being video monitored while delirious and during his return to baseline; his impressions varied depending on his phase of recovery. While very delirious, the patient stated that being monitored made his anxiety significantly worse. He felt compelled to lay motionless in bed saying, “if I moved a muscle I was afraid someone was going to yell at me right away.” At times he believed the video monitoring device was a staff member standing over him, watching him. As his mental status improved, the patient was angered by the presence of the camera. He felt his dignity and privacy were not being respected.    Nursing staff on the inpatient unit had mixed views on the utility of video monitoring. Some appreciated the utility for confused, high fall-risk patients who respond well to verbal reminders to ask for assistance when getting out of bed. Others felt that video monitoring can complicate care of patients who frequently try to get out of bed and don’t respond to verbal cues, requiring physical assistance from staff to stay safe. Many staff members reported increased patient anxiety during video monitoring.    It is clear from your article, the existing body of literature on the importance of social relationships in health outcomes, and our anecdotal experiences that the use of remote video monitoring may not be the boon it was promised to be. We suggest that the medical community needs to examine the potential negative impacts on patient outcomes and balance those against the potential economic and staffing benefits.     References   1. Mirza NA, Christian JA, LaJeunesse C. Remote video monitoring is another example of “dying on the machine” for critically ill patients. Clin. Res. Prac. 2017;3:eP1517. doi: 10.22237/crp/1498867800   2. Uchino B. Social support and health: a review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine. 2006 Jun; 29(4):377-87. doi: 10.1007/s10865-006-9056-5   3. Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health. Psychological Bulletin. 1996;119(3):488-531.doi:10.1037/0003-2909.119.3.488 4. Cohen S. Social relationships and health. American Psychologist. 2004 Nov; 59(8):676-84. doi: 10.1037/0003-066X.59.8.676  

Letter to the Editor: Patient and Staff Experiences with Inpatient Video Monitoring

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Letter to the Editor: Patient and Staff Experiences with Inpatient Video Monitoring

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