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To examine the reasons for and methods of using remote video monitoring to prevent falls across hospital and residential aged care, and explore how staff, patients, residents and families perceive its use and benefits.
Scoping Review.
Following JBI methodology, eight databases were searched in July 2025 with no date restrictions. Two reviewers independently screened studies using predefined criteria, and one reviewer extracted data. Narrative and thematic syntheses described how video monitoring is implemented for falls prevention and explored stakeholders' attitudes.
Thirty-five studies were included, with 77% conducted in hospitals and 86% focusing on staff perspectives, highlighting a critical underrepresentation of patients/residents and families. Perceived effectiveness was shaped by underlying motivations—falls prevention, workforce optimisation, or cost reduction. Attitudes were influenced by workload impacts, video monitoring knowledge, ethical and liability concerns. Three remote video monitoring models were identified: technician-based, automated alerts, and nurse-observed without alerts. Technician-based systems were only in hospitals, with no equivalent in aged care.
Research on remote video monitoring for falls prevention is heavily weighted towards hospitals and staff perspectives. Nurses generally viewed video monitoring as effective but still preferred in-person observers. Although there is interest in innovative monitoring systems in aged care that balance safety with a homelike environment, empirical research is lacking. Patient, resident, and family experiences remain underrepresented and require further research.
Remote video monitoring has emerged as an alternative to mobilisation alarms, given their uncertain effectiveness and negative consequences for patients and nurses. Much U.S. hospital research reflects a cost-reduction paradigm aimed at replacing in-person observers, a trend not seen internationally or in aged care. This research is relevant to decision-makers considering technological options for falls prevention and to nurse leaders seeking insight into the appeal and apprehension surrounding video monitoring.
PRISMA-ScR.
None.
To explore why and how staff use alarms for falls prevention in hospital and their alignment to person-centred practice.
Qualitative interpretive design.
One hundred focus groups and 25 interviews across 10 health services were completed between October 2022 and September 2024. Participants included nurses (n = 451), allied health (n = 82), and fall prevention managers (n = 18). The Framework Method guided initial data familiarisation and analysis and led to the Person-Centred Practice Framework being identified as a useful framework.
Themes generated: (1) Understaffed, under-resourced, under pressure, (2) Alarm impact on stress and workload, (3) Negotiating patient safety and patient preference, (4) Engaging family as a resource, (5) Sharing responsibility for alarms and falls prevention, and (6) Navigating ambiguity and fearing consequences.
Staff feel compelled to use alarms despite problems associated with their use and challenges to person-centred practice. Drivers of alarm use were feeling under-resourced and fearing liability if patients fell. Staff want clearer organisational guidance in alarm use but also want the freedom to use their own clinical reasoning.
Hospitals worldwide are working to identify effective strategies for preventing falls. However, research has yet to adequately explore the perspectives of frontline nurses and allied health staff regarding the use of mobilisation alarms—a critical gap when evaluating their impact and effectiveness. This study's six key themes provide insights into why alarms are so widely used despite the limited evidence supporting their effectiveness.
Consolidated Criteria for Reporting Qualitative Research.
This study did not include patient or public involvement in its design, conduct, or reporting.
Australian New Zealand Clinical Trials Registry ACTRN12621000823875.
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