Quiet Time Improves the Patient Experience

Hedges, Christine; Hunt, Candice; Ball, Pamela

doi:10.1097/ncq.0000000000000363

Cited by 22 publications

(6 citation statements)

References 21 publications

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“…Examinations, physiotherapy, and other interventions should be avoided during this period; some also recommend avoiding family visits at this time. Research on patients' melatonin secretion during quiet time has not been conclusive, but patients have reported better sleep quality and less anxiety in studies implementing quiet time in the ICU (Hedges et al, 2019;Maidl et al, 2014). Although this is another low-cost intervention, it may be less feasible.…”

Section: Data Sourcesmentioning

confidence: 99%

Promoting Sleep in the Intensive Care Unit

Edvardsen

Hetmann

2020

SAGE Open Nursing

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Introduction Intensive care nurses face several challenges to facilitating sleep in their critically ill patients. With its high noise levels, hectic around-the-clock activity and constant artificial lights, the intensive care environment does not foster sleep. Intensive care unit patients have significant alterations in their sleep architecture with frequent awakenings and lighter sleep; up to 50% of this sleep also occurs during the daytime. Sleep loss increases the risk of developing delirium (especially in elderly patients) and immune system impairment, which prolongs healing. The aim of this article was to develop an evidence-based bundle of nursing care activities that promote adult intensive care patients’ sleep. Methods A broad search was conducted in PubMed, CINAHL, Cochrane Library, and McMaster plus using search words and Medical Subject Headings terms, such as sleep, intensive care unit, intensive care, critical care nursing, sleep promotion, music, white noise, earplugs, pain relief, absence of pain, nonpharmacological intervention, and mechanical ventilation. Eight recommendations emerged from this review: reduce noise, use earplugs and eye masks, use music, promote a natural circadian rhythm, manage pain, use quiet time, cluster nursing care activities at night, and optimize ventilator modes. Conclusion Promoting sleep within this patient population needs to be a higher priority for intensive care nurses. Sleep should be a focus throughout the day and night, in order to sustain patients’ natural circadian rhythms. Novel research in this field could change the strength of these recommendations and add new recommendations to the bundle.

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Section: Data Sourcesmentioning

confidence: 99%

Promoting Sleep in the Intensive Care Unit

Edvardsen

Hetmann

2020

SAGE Open Nursing

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“…This pilot project demonstrated that the use of an evidencebased innovation limiting the use of virtual screen time at night and bundled care prior to sleep hours increased hours of sleep and decreased sleep interruptions among pediatric patients and their caregivers who stayed at bedside overnight. [21][22][23][24] While it is not possible to determine whether the reduced screen time and nighttime curfew and bundled care were the sole reasons of enhanced sleep among participants, it is theorized that by eliminating the blue light exposures and Fig. 2 (A) A majority of children admitted with respiratory conditions (n ¼ 44, 77.2%) due to enterovirus (n ¼ 8, 14.0%), human meta-pneumovirus (n ¼ 9, 15.8%), parainfluenza (n ¼ 12, 21.1%), pneumonia (n ¼ 3, 5.3%), bronchiolitis (n ¼ 11, 19.3%), and tuberculosis (n ¼ 1, 1.8%) infections.…”

Section: Discussionmentioning

confidence: 99%

“…This pilot project demonstrated that the use of an evidence-based innovation limiting the use of virtual screen time at night and bundled care prior to sleep hours increased hours of sleep and decreased sleep interruptions among pediatric patients and their caregivers who stayed at bedside overnight. 21 22 23 24…”

Section: Discussionmentioning

confidence: 99%

Quiet Time Means No Screen Time: A Project Aiming to Increase Restful Sleep within the Pediatric Acute Care Unit

Vildor,

Derouin,

Waldrop

et al. 2024

J Pediatr Intensive Care

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The use of blue-light-emitting smart devices prior to bedtime has been identified as one of the reasons of increased pediatric sleep disturbances and poor sleep quantity. Interrupted sleep is a risk factor for healing and well-being in the pediatric acute ward. The aim of this project was to promote high-quality sleep within our pediatric ward by implementing a standardized protocol that eliminated exposure to electronic blue light prior to bedtime, per recommendations from the American Academy of Pediatrics. Our objective was to promote enhanced quantity of sleep and healing by restricting and removing all smart devices during nighttime hours in the pediatric acute ward. We utilized the Bedtime issues, Excessive daytime sleepiness, night Awakenings, Regularity and duration of Sleep, and Snoring validated screening tool, Children Sleep Habit Questionnaire, and included a survey question regarding smart device use to evaluate patients' sleep routine. After the implementation of “no screen time” innovation, patients' and parents' quantity of sleep and total restful hours was reassessed and pre/post results analyzed. The pilot project evaluated 57 patients aged 18 months to 19 years with varying admitting diagnoses. The quiet time innovation results demonstrated improved length and reported uninterrupted sleep among patients. Eliminating electronic screens during evening (sleeping) hours in the acute care setting was associated with improved sleep among pediatric patients, enhancing potential for recovery, promoting well-being, and modeling effects of limiting screen time for participants.

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“…Sleep is well-documented to benefit health outcomes by decreasing recovery time and medical complications and a lack of it is correlated with both increased morbidity and mortality (5). However, most hospital settings are often subject to constant commotion and frequent disruptions that prevent patients from receiving adequate sleep and thus interfere with patient experience (5)(6)(7). Thus far no studies have analyzed the CMS data to qualify the types of hospitals that score well on this question.…”

Section: Introductionmentioning

confidence: 99%

Which Hospitals Promote a Sleep-Friendly Patient Experience?

Gulati

Arora

McDaniel

et al. 2023

Journal of Patient Experience

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The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient perceptions of hospital experience to determine the annual Center for Medicare and Medicaid Services (CMS) reimbursement. This study focuses on the “Quiet at Night” variable and identifies institutions with the highest scores to determine characteristics that facilitate patient sleep. The key findings were as follows: CMS Top Rated Hospitals have a mean score of 5 on the “Quiet at Night” variable. US News Honor Roll Hospitals have a mean score of 2.67, with a statistically significant difference of P < .001 between the groups. The key characteristics of the CMS Hospitals are that they are predominantly privately owned, specialized, surgical facilities with few total hospital beds. Knowing that HCAHPS scores directly impact and reflect patient experience, the objective of this study was to better understand the hospital practices that facilitate a high score on the “Quiet at Night” question to empower low scoring hospitals to improve their sleep practices at night and to score higher on the HCAHPS survey.

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Quiet Time Improves the Patient Experience

Abstract: Noise in hospitals is often beyond the scope of nurse-driven improvement; however, a QT protocol led by nurses, developed by multiple stakeholders, and focused on changing expectations for quiet can lead to measurable improvements in patient perception of quiet.

Cited by 22 publications

References 21 publications

Promoting Sleep in the Intensive Care Unit

Promoting Sleep in the Intensive Care Unit

Quiet Time Means No Screen Time: A Project Aiming to Increase Restful Sleep within the Pediatric Acute Care Unit

Which Hospitals Promote a Sleep-Friendly Patient Experience?

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