Decrease in as‐needed sedative use by limiting nighttime sleep disruptions from hospital staff

Bartick, Melissa; Thai, Xia C.; Schmidt, Timothy H.; Altaye, Amsalework; Solet, Jo M.

doi:10.1002/jhm.549

Cited by 66 publications

(62 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results for reported sleep duration and VSH scores are consistent with previous reports in general medicine patients [7,13, 14]. We also performed a comprehensive survey of factors that may be associated with nighttime sleep quality, using three different quality measurements (Table 1).…”

Section: Discussionsupporting

confidence: 89%

Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population

et al. 2016

View full text Add to dashboard Cite

BackgroundSleep quality in hospitalized Canadian General Internal Medicine patients is not well characterized. Our goals were to characterize hospital sleep quality in this population and identify potentially modifiable barriers to good sleep.MethodsGIM inpatients at a quaternary centre in Edmonton, Canada completed a survey, including the Verran-Snyder Halpern (VSH) questionnaire, to characterize the previous night’s sleep within 48 hours prior to discharge. A chart review was also completed to assess comorbidities, discharge diagnoses, and pharmaceutical sleep aid use.ResultsPatients reported significantly worse nighttime sleep duration in hospital compared with home (mean 5.5 versus 7.0 hours per night, p < 0.0001). Sleep quality was poor, as measured by the VSH disturbance (mean 371), effectiveness (190), and supplementation (115) subscales. Variables independently associated with poorer sleep duration in multivariable regression include prior diagnosis of sleep disorder and multi-patient occupancy rooms. Age, sex, admitting diagnosis, length of stay, frequency of vital checks, and use of sleep pharmaceuticals during the index hospitalization were not associated with sleep duration. The most frequently reported reasons for poor sleep included noise (59%), nursing interruptions (30%), uncomfortable beds (18%), bright lights (16%), unfamiliar surroundings (14%), and pain (9%).ConclusionsSleep quality for GIM inpatients is significantly worse in hospital than at home. There is a need to test non-pharmacologic interventions to address the most frequently identified factors causing poor sleep hygiene for GIM inpatients.

show abstract

Section: Discussionsupporting

confidence: 89%

Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Previous studies indicated that initiating quiet times was successful in decreasing noise levels 20,23 and in improving patients' sleep quality. 2,33 Further, as mentioned earlier, low mean SPLs should not be interpreted as an indication that disturbing sounds are not present. In future, an analysis to determine the sources of the peak SPLs should be conducted, as should interviews with patients to determine which sounds they find most disturbing, so that measures can be taken to decrease the sources of those specific sounds.…”

Section: Discussionmentioning

confidence: 91%

“…8 A lack of sleep has also been associated with, but is not necessarily the cause of, ICU delirium. 32 Recently, Bartick et al 33 reported that decreasing sleep disruptions by lowering lighting levels, having nurses avoid waking patients for measurement of vital signs, and instigating a "quiet time" resulted in decreased use of sedatives among patients.…”

mentioning

confidence: 99%

Sound Intensity and Noise Evaluation in a Critical Care Unit

Lawson

Thompson

Saunders

et al. 2010

American Journal of Critical Care

View full text Add to dashboard Cite

Background Sound levels in intensive care units can be high. Unfortunately, high levels of sound tend to result in poor sleep quality, which leads to slower healing, poorer immune response, and decreased cognitive function. Objectives To measure sound levels to which patients in intensive care units are typically exposed. Methods Peak sound pressure levels of alarms on medical devices set at different output levels were measured. Additionally, ambient sound pressure levels for durations of 10 to 24 hours were measured on 12 occasions in patients' rooms in the intensive care unit. Results Peak levels of equipment alarms measured inside a patient's room were high, and increased as the setting of the alarm level increased. The levels of these alarms when measured in an adjacent room did not increase with alarm output level. Mean sound levels inside the patient's room were generally less than 45 dB(A), but peak levels were often greater than 85 dB(C). Closing the door of the adjacent room did not decrease these peak levels. Peak and mean levels did not differ systematically during 24 hours of measurement. Conclusions High-intensity equipment alarms disturb patients' sleep but are critical in a medical emergency. However, nurses should not assume that raising the alarm output level will ensure that the alarm is audible from an adjacent room. Ambient noise measurements indicate high peak levels during both day and night. (American Journal of Critical Care. 2010;19:e88-e99)

show abstract

“…(38) Furthermore, interventions that reduce the stress of hospitalization by optimizing sleep and keeping patients mentally and physically active during their stay may have a beneficial effect on medication adherence after discharge. (39)…”

Section: Discussionmentioning

confidence: 99%

Impact of Hospitalization for Acute Myocardial Infarction on Adherence to Statins Among Older Adults

Kronish

Ross

Hong

et al. 2016

Circ: Cardiovascular Quality and Outcomes

View full text Add to dashboard Cite

Background Little is known about the impact of hospitalization for an acute myocardial infarction (AMI) on subsequent adherence to statins. Methods and Results Using administrative claims from a 5% random sample of Medicare beneficiaries, we identified a cohort of Medicare patients ≥65 years, hospitalized from 2007–2011, taking statins in the year before AMI hospitalization (n=6,618). We then determined the proportion of patients nonadherent to statins (proportion of days covered [PDC] <80%) in the year before AMI hospitalization who became statin adherent (PDC ≥80%) in the year after AMI hospitalization. The proportion of statin adherent patients who became nonadherent was also studied. These proportions were compared with patients hospitalized for pneumonia (n=11,471) and patients not hospitalized (n=158,099) in 2010 and 2011. Among patients nonadherent to statins before AMI hospitalization, 37.7% became adherent after discharge. Patients hospitalized for AMI were more likely to become adherent than patients hospitalized for pneumonia (aRR 1.70, 95%CI 1.57–1.84) or patients not hospitalized (aRR 1.79, 95%CI 1.68–1.90). Among patients adherent to statins before AMI hospitalization, 32.6% became nonadherent after discharge. Those hospitalized for AMI were less likely to become nonadherent than those hospitalized for pneumonia (aRR 0.93, 95%CI 0.88–0.98) but more likely to become nonadherent than patients without hospitalizations (aRR 1.41, 95%CI 1.35–1.48). Conclusions Among nonadherent patients, hospitalization for AMI was associated with increased likelihood of becoming adherent to statins compared to hospitalization for pneumonia or no hospitalizations. Among adherent patients, hospitalization for AMI was associated with increased likelihood of becoming nonadherent to statins compared to no hospitalizations.

show abstract

Decrease in as‐needed sedative use by limiting nighttime sleep disruptions from hospital staff

Abstract: Small modifications in hospital routines, especially in the timing of vital signs and routine medication administration, can significantly reduce sedative use in unselected hospital patients.

Cited by 66 publications

References 26 publications

Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population

Sleep Quality and Factors Influencing Self-Reported Sleep Duration and Quality in the General Internal Medicine Inpatient Population

Sound Intensity and Noise Evaluation in a Critical Care Unit

Impact of Hospitalization for Acute Myocardial Infarction on Adherence to Statins Among Older Adults

Contact Info

Product

Resources

About