PONE-D-22-29007The use of patient sitters at a Swiss hospital: A retrospective observational studyPLOS ONE

Dear Dr. Kramer,

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Manuscript shows the inpatients sitter figure during one year.

Abstract.

Line 26: “voluntary sitter”: familiar? Hospital service? Are they been paid or it is full voluntary?

Line 26: “median duration” a day? Week? total stay?

Introduction.

Line 77: this paragraph solves a lot of doubts that arises me when I have started to read the manuscript. Could you try to place it before?

Line 115: delete the “W” at the end of the paragraph.

Introduction must be rewritten. Content is quite good but I cannot find a logical order. Start with the definition and characteristics that these sitters have and after that explain that literature and different settings have in relation with this figure.

Material and methods

Line 118 and 119: this sentences does not make sense. Rewrite.

Line 119: “certain characteristics”: which ones?

Line 125: sitters are part of the paid professionals who work in this hospital, isn´t it?

Line 133-154: I understand that there is no consensus about the characteristics of this figure must do (type of patient, type of care, number of hours…) but this section looks a bit abstract, because there is any line that justify a standard work of the sitter person.

Line 177, data collection: if the sitter is a voluntary familiar, How did you collect data (number of hours for example)?

Line 223: “the large amount of test” is not a justification for not to ask for an informed consent. Patients must be informed about their data will be analyzed.

Results.

Line 232-233: some comment mention at the abstract section, daily median hours (of course not, it is an example for you), weekly?...

Line 233: if you write numbers with numbers, please write 4 instead of “four”.

Line 255, table 1: although men is the rest of the sample, please add this information in the table too.

Line 294: please try to improve the quality of both figures.

Discussion.

Line 327: you do not mention nothing about suicidal in your results, or in general any specific cause for the need of a sitter.

Line 332: some comment regarding the mortality.

Additional comments:

Are there any criteria to assign this sitter to patients?

I have no clear if this figure is part of the hospital or a familiar of the patient….

If patient is a familiar number of hours are often too much than personal care professional with a schedule (conditioning by the visit regime of the hospital), besides, if the sitter is a familiar, does not affect the hospital organization.

There is no mention about the cost of these sitters in your study.

It is not clear us sitters are always nurses in your study or not, because you have not explained anything about this issue in the sitters mentioned in this sample.

Reviewer #2: Dear authors,

I think that the introduction should be simplified by using expressions that indicate the importance of the subject.

‘’On the other hand, the kind of continuous observation that patient sitters provide is considered a restriction of personal liberty and thus, too, qualifies as a restraint measure under the Children and Adult Protection Act, which came into effect in Switzerland on January 1, 2013.’’ If the type of observation provided by patient sitters for these statements you discussed in the introduction is considered to be a restriction of freedom, why was it necessary to conduct such a study? Question must be answered.

In the "Study sample" section, you should explain why patients who required at least four hours of paid or volunteer patient sitters were included in the study.

By making the definitions of volunteer and paid patient sitter broader, you should explain more clearly who is volunteer and who is paid. How is the usage period of the patient sitter determined in the system? Is there any clear information as you stated?

"Nursing workload measured in minutes" was this workload calculated based on what data?

The discussion part of the research needs to be elaborated a little more, for example, I think that the parts such as the months with the highest use of caregivers, the nursing workload should be discussed in the discussion or discussed in a more comprehensive way.

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Reviewer #1: No

Reviewer #2: No

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The use of patient sitters at a Swiss hospital: A retrospective observational study

PONE-D-22-29007R1

Dear Dr. Kramer,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Federica Canzan

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear Authors,

In relation with my comment (line 332), there is a mistake. I wanted to write "sAme comment regarding the mortality" (like my previous comment about suicidal information). Because before the discussion section any comment about mortality had been done.

Thank you very much for considering my suggestions. Manuscript looks much clerarer for me.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

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