Quiet Please! The effects on sleep quality and quantity as a result of QI project to minimize nighttime interruptions
INTRODUCTION: Sleep is a significant component of health that is often overlooked in hospitalized patients. We introduced a QI project in 2016 to minimize nighttime interruptions in clinically stable patients by performing “passive vitals” which eliminated temperature and blood pressure readings at 4am and allowed patients to sleep longer overnight. Despite this intervention, the effects on sleep quality and quantity are unknown.
OBJECTIVE: The objective was to compare total sleep time, sleep interruptions, and sleep quality between patients eligible for passive vitals and those ineligible through survey data collected from July to November 2019.
METHODS: Participants eligible and non-eligible for passive vitals self-reported the number of hours of sleep, number of nighttime awakenings, awakenings attributed to hospital staff, and elaborated on reasons for poor sleep. The survey also allowed previously hospitalized patients to compare the current stay to those in the past by assessing their quality of sleep and how tired they felt upon waking using a 5-point scale. Data was analyzed using Chi-square test.
RESULTS: Forty-eight eligible and fifty-six non-eligible patients were surveyed. The total hours of sleep between groups was not statistically significant (p=0.11). There were no significant differences in the number of total sleep interruptions (p=0.95) and those by hospital staff (p =0.55). For patients who were previously hospitalized, there were no significant differences in sleep quality rating (p=0.10) and how tired they felt the next morning (p=0.78). Both groups cited similar reasons for poor sleep including care-related and illness symptom-related disruptions most commonly, followed by environmental-related complaints.
DISCUSSION: The total hours of sleep, number of sleep interruptions, sleep quality, and rating of tiredness did not differ among the eligible and non-eligible groups. Many factors contributed to poor overall sleep which cannot be mitigated by passive vital signs in eligible patients at 4am. Other factors will need to be addressed
