How Do Clinicians Assess, Communicate About, and Manage Patient Sleep in the Hospital?

Ye, Lichuan; Keane, Kathleen; Johnson, Stacy; Dykes, Patricia C.

doi:10.1097/nna.0b013e3182942c8a

Cited by 34 publications

(40 citation statements)

References 7 publications

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“…Clinicians typically receive little training regarding sleep or its importance. In fact, most clinicians do not assess or communicate about the patient's quality of sleep . Many may not know that there is little evidence of benefit of pharmacological sleep aids in the hospital.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, most clinicians do not assess or communicate about the patient's quality of sleep. 11 Many may not know that there is little evidence of benefit of pharmacological sleep aids in the hospital. For example, a recent report found, in contrast to the authors' hypothesis, no changes in sleep architecture or duration using 10 mg of zolpidem tartrate in postoperative patients.…”

Section: Discussionmentioning

confidence: 99%

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Inpatient pharmacological sleep aid utilization is common at a tertiary medical center

Gillis

Poyant

DeGrado

et al. 2014

Journal of Hospital Medicine

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BACKGROUND Sleep is known to be poor in the hospital. Patients frequently request pharmacological sleep aids, despite the risk of altered mental status (delirium) and falls. Little is known about the scope of pharmacological sleep aid use in hospitalized patients. METHODS We performed a single center, retrospective review of all patients admitted to the general adult (age >18 years) medical and surgical units of a tertiary care center during a recent 2‐month period (January 2013–February 2013). Review of the electronic medication administration system was performed to assess for medications administered for sleep. RESULTS Of 642 unique admissions, 168 patients (26.2%) received a medication for sleep. Most (n = 115, 68.5%) had no known history of insomnia or regular prior sleep medication use. Patients most frequently were treated with trazodone (30.4%; median dose, 50 mg; range, 12.5–450 mg), lorazepam (24.4%; median, 0.5 mg; range, 0.25–2 mg), and zolpidem tartrate (17.9%; median, 10 mg; range, 2.5–10 mg). Of the medications given, 36.7% were given early (before 9 pm) or late (after midnight). Of patients not known to be previously taking a pharmacological sleep aid, 34.3% of them were discharged with a prescription for one. CONCLUSIONS Despite increasing evidence of risks such as delirium or falls, pharmacological sleep aid use in general wards remains common, even in elderly patients. Medication administration time is frequently suboptimal. Many previously sleep medication‐naïve patients leave the hospital with a sleep aid prescription. Further research is needed to understand the factors that contribute to the high rate of sleep medication use in hospitalized patients. Journal of Hospital Medicine 2014;9:652–657. © 2014 Society of Hospital Medicine

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Inpatient pharmacological sleep aid utilization is common at a tertiary medical center

Gillis

Poyant

DeGrado

et al. 2014

Journal of Hospital Medicine

Self Cite

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“…Studies indicate that healthcare professionals do not have sufficient knowledge to actively work to promote patients' sleep (Hopper, Fried, & Pisani, 2015;Radtke, Obermann, & Teymer, 2014) and show that patients' sleep is not explicitly incorporated as a subject in nursing education (Huang, Liao, Chang, & Lai, 2018;McIntosh & MacMillan, 2009). Ye et al (2013)…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…Studies indicate that healthcare professionals do not have sufficient knowledge to actively work to promote patients’ sleep (Hopper, Fried, & Pisani, ; Radtke, Obermann, & Teymer, ) and show that patients’ sleep is not explicitly incorporated as a subject in nursing education (Huang, Liao, Chang, & Lai, ; McIntosh & MacMillan, ). Ye et al () found that healthcare staff do not discuss sleep with patients enough and do not use assessment tools to identify and initiate nursing interventions to promote better sleep.…”

Section: Introductionmentioning

confidence: 99%

“…Many patients describe sleeping in hospital as a stressor, and nurses tend to underestimate patients' perceived problems with sleep during hospitalisation (Kamdar et al, 2012;Ritmala-Castren, Axelin, Kiljunen, Sainio, & Leino-Kilpi, 2017;Ritmala-Castren et al, 2016). Despite this, patients' sleep appears not to be prioritised in nursing (Gellerstedt, Medin, Kumlin, & Rydell Karlsson, 2015;Ye, Keane, Hutton Johnson, & Dykes, 2013). Several studies show that patients' sleep is disturbed during hospitalisation and that most patients experience impaired sleep quality.…”

Section: Introductionmentioning

confidence: 99%

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Nursing care and management of patients’ sleep during hospitalisation: A cross‐sectional study

Gellerstedt

Medin

Kumlin

et al. 2019

Journal of Clinical Nursing

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Aim To explore and describe how patients’ sleep is addressed at acute‐care hospitals in Sweden with regard to nursing care, management and the development of knowledge in this area. Background Sleep is a basic human need and thus important for health and health maintenance. Patients describe sleeping in hospital as a stressor, and research shows that nurses tend to underestimate patients’ perceived problems with sleep during hospitalisation. How do nursing staff at acute hospitals address patients’ sleep and the development of knowledge in this area? Design/Method A cross‐sectional descriptive study was conducted based on data collected through a web survey. Head nurses, registered nurses, nursing care developers and local training supervisors at 36 randomised acute‐care hospitals in Sweden were invited to participate. This study was executed and reported in accordance with SQUIRE 2.0. Results The results of the survey (53 responses from 19 wards at 15 acute‐care hospitals) showed that no policy documents exist and no current training addresses sleep during hospital stay. All participants agreed that sleep should be considered a nursing topic and that it is important for hospitalised patients. Conclusion Patients’ sleep during hospitalisation is undermanaged at acute‐care hospitals. Nurses, health care managers and organisations face challenges if they are to achieve better outcomes. Relevance to clinical practice This study shows that nurses do consider patients’ sleep important and addressing sleep as part of nursing care. Future studies in the area should focus on what kinds of support and education are needed in the clinical context.

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Randomized clinical trial of psychological support and sleep adjuvant measures for postoperative sleep disturbance in patients undergoing oesophagectomy

Scarpa

Pinto

Saraceni

et al. 2017

British Journal of Surgery

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How Do Clinicians Assess, Communicate About, and Manage Patient Sleep in the Hospital?

Abstract: It is critical to inform clinicians on the importance of sleep, to standardize sleep assessment, and to facilitate collaboration among caregivers to promote sleep for hospitalized patients.

Cited by 34 publications

References 7 publications

Inpatient pharmacological sleep aid utilization is common at a tertiary medical center

Inpatient pharmacological sleep aid utilization is common at a tertiary medical center

Nursing care and management of patients’ sleep during hospitalisation: A cross‐sectional study

Randomized clinical trial of psychological support and sleep adjuvant measures for postoperative sleep disturbance in patients undergoing oesophagectomy

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