From the 2024 HVPA National Conference
Alexander Lo BS (UC San Diego School of Medicine), Mitchell Wong BS, Alan Moazzam MD, Stephanie Abdulrahman RN, Reid Sasaki MD, Gregory Seymann MD
Hospitalized patients have difficulty getting adequate amounts of sleep. Poor sleep has been shown to increase incidence of delirium and inhibits the body’s process of healing. Factors contributing to less sleep include illness, and disruptions of circadian rhythms from lab draws and medication administrations. This study compares several metrics related to sleep quality in hospitalized patients with or without administration of phased interventions designed to improve their quality and quantity of sleep.
Two separate cohorts of hospitalized patients were followed in this study. The first was a control group who received no interventions besides standard hospital care. The second cohort received nurse-adminstered sleep interventions. The cohort groups were compared by: age, sex, LACE scores, responses to the Richards-Campbell Sleep Questionnaire, and DOSS scores. We also collected data on HCAHPS and sitter hours.
All questionnaire responses, except for noise level, were significantly different between the two cohorts. Compared to controls, patients in the intervention cohort reported to a higher degree that they got deep sleep (32.9% higher, p = 0.0056), took a short time to fall asleep (36.4% higher, p = 0.0003), had few awakenings in the night (23.2% higher, p =0.0079), and felt that their overall sleep quality was good (34.2% higher, p = 0.0002). There was also a statistically significant 8.47% increase in patient satisfaction with the room quietness at night (P=0.0007), based on the HCAHPS survey. Also, we observed a reduction of 896 reduced sitter hours, translating to $21,351.68 in cost savings. The process of activation of the sitters was standardized by the UCSD Health institutional sitter policy.
Our results show the potential for nurse-driven interventions to enhance inpatient sleep quality, quantity, and satisfaction, along with improved patient satisfaction and cost savings to the hospital.