Do you know anyone who’s ever had a good night’s sleep in the hospital? As nurses, we hear the complaints; as patients ourselves, or as family members of patients, we’ve been there.

Differing views on the source of a unit’s sleep problem.

After their hospital’s 20-bed telemetry unit received a low HCAHPS survey score on a quiet-at-night question, nurse practitioner Christian Karl Antonio and his colleagues at a northern California community hospital took on the challenge of improving patients’ sleep experience on the unit.

Before designing an intervention, they spoke with patients as well as staff, and were surprised to learn that the two groups see the problem differently.

“Patients perceived being awakened for vital signs, blood draws, and medication administration as the most frequently occurring factors that contributed to noise at night. On the other hand, staff members perceived that noise at night came from staff conversations, equipment with alarms, announcements on the paging system, and delivery carts, among other sources.”

A ‘sleep menu’ and other measures pay off.

Based on these findings, along with a literature review, the team developed a “sleep menu.” Patients could select their intervention(s) of choice from a list of options such as “keep door closed” or “ear plugs.” The project also included staff education and hourly rounding by unit champions and assistant nurse managers to encourage patients to use the sleep menu and to continue to gather input from patients.

These efforts paid off.  Among other positive outcomes:

“Five or more hours of uninterrupted sleep per night were reported by 31% of patients in the baseline group, compared with 80% of patients in the intervention group…”

To learn more, read the entire article, “Improving Quiet at Night on a Telemetry Unit: Introducing a Holistic Sleep Menu Intervention,” which is free until the end of October.