The sleep hygiene bundle is composed of a short script with sleep hygiene prompts, such as whether patients would like the shades closed or the lights turned off, as well as a sleep package including an eye mask, ear plugs, lavender scent pad and non-caffeinated tea. Relaxing music was played at bedtime, and signs promoting the importance of quietness at night were placed around the unit. Front-line champions were identified to aid with the implementation.

A total of 931 patients received the sleep intervention. In a sample of surveyed patients, the RCSQ global score increased from 6.0 to 6.2 from the pre- to post-intervention periods, as well as in three of the five individual survey components. Additionally, the HCAHPS “quietness at night” score increased from 34.1% to 42.5% from the pre- to post-intervention periods.

The researchers conclude that a non-pharmacologic sleep hygiene protocol, paired with provider education and use of champions, were associated with modest improvements in patients’ perceived sleep.

“As we consider this study, it is worth noting that hospital sleep is not just a patient experience issue; it also can exacerbate chronic health issues for many adult patients. Even short-term disruptions in sleep lead to deleterious effects on metabolic regulation, immune function, wound healing, mental health and development of delirium,” notes an accompanying editorial by Nancy H. Stewart, DO, MS, and Vineet M. Arora, MD, MAPP.

Also featured in the June issue:

• Prescribing Naloxone to High-Risk Patients in the Emergency Department: Is it Enough? (editorial)
• Developing and Implementing a Dedicated Prone Positioning Team for Mechanically Ventilated ARDS Patients During the COVID-19 Crisis (New York Presbyterian Hospital)
• Use of a Novel Patient-Flow Model to Optimize Hospital Bed Capacity for Medical Patients (Northwestern Memorial Hospital, Chicago)
• Increasing Naloxone Prescribing in the Emergency Department Through Education and Electronic Medical Record Work-Aids (Duke University Hospital, Durham, North Carolina)
• Assessing Patients’ Experiences with Medical Injury Reconciliation Processes: Item Generation for a Novel Survey Questionnaire (University of New South Wales, Sydney, Australia)
• Development of a Novel and Scalable Simulation-Based Teamwork Training Model Using Within-Group Debriefing of Observed Video Simulation (Brigham & Women’s Hospital, Boston)
• Sentinel Event Alert 63: Optimizing Smart Infusion Pump Safety with DERS (The Joint Commission, Oakbrook Terrace, Illinois)

For more information, visit The Joint Commission Journal on Quality and Patient Safety website. 

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The Joint Commission Journal on Quality and Patient Safety
The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered.

1 Ding Q, et al. Factors influencing patients’ sleep in the in- tensive care unit: perceptions of patients and clinical staff. Am J Crit Care. 2017;26:278–286.