RHCI has developed the Patient Sitter Program in response to the needs of the Traumatic Brain Injured (TBI) patients in the acute care setting. "In the short time since the program began, it has already allowed us the flexibility to take patients from the acute care hospitals sooner," says Martha Hunter, RN, BSN, MBA, Nursing Director and Chief Nursing Officer.
For the patient with a TBI, the transition from the acute care to the rehabilitation hospital can pose many challenges for the healthcare team. The pathology that is representative of a TBI patient ranges from cognitive to behavioral challenges as well as physical limitations. Restlessness, agitation, impaired thinking as well as impulsivity need to be constantly monitored.
Historically, addressing the needs of patient safety and constant observation has been a function of a nurse or nurse's aide who was assigned to the patient on a 24/7 basis. Meeting this need has typically placed a burden on facilities, both in terms of extra staff to provide for the one-to-one needs of these patients and the associated additional costs. Without this resource, patients in the acute hospital setting would have to stay in the hospital until they no longer needed one-to-one care. At that point they often fell out of level for acute rehabilitation.
The Sitter Program offers a solution to the through-put, staffing and financial issues. "Our observations indicate that most of the TBI patients only need a companion-level individual instead of a trained clinician to ensure a safe environment," states Martha. RHCI sitters are carefully screened and attend a training program given by the hospital's Neurobehavioral Social Worker. The program began in June, 2009 with four individuals and has now grown to 17. "Our goal is to grow a robust program to answer the needs of the acute care facilities," adds Martha.
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