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Improving Patient Sleep
Patients average only 5h per night of sleep (0-10h range)
Poor sleep associated with weakened immune systems & poor cognitive function
Sleep loss linked to alterations in
the neuroendocrine, immune and inflammatory systems (also hypertension)
1% stated sleep was excellent or very good (n=186) in hospital (pre-intervention); 24% (post intervention) in one study
http://journals.rcni.com/doi/pdfplus/10.7748/ns.29.28.35.e8947
www.drugguide.com www.drugs.com
Dr. David Lyness (NHS, UK)
Mr. Mark Dornan (Student,UK)
Other patients - snoring, mobile phones, laptops
Ward Environment - light, heat, noise, humidified O2, nebulizers, alarms, bins
Equipment - call bells, telephones, bleeps, printers, monitors, BP cycles
Staff - voice, footwear, late rounds, early morning deliveries
- Use of eye masks & ear plugs
- Mobile phones on silent
- Early/timely medications round
- Sleeping Tablets Given Early Enough
- Visiting Limited to Emergencies
- Restrict caffeinated drinks!
- Staff are quiet on the ward
- Limit non-essential activity
Zopiclone - rapid onset; duration 3-9h
Temazepam - onset 1.2-1.6h; half-life 3.5-18.4h
Interventions = 'Good Sleep Checklist' at Night
- Alarms answered timely
- No unnecessary alarms
- Reduce the ringer volume on ward phones
- Mobile phones turned on silent from 9pm
- Televisions off at 10pm
- Blinds & Curtains closed (when appropriate)
- Rubber shoes
- Headphones used if still awake
- Turn off suction units if not in use
- Close kitchen/sluice/toilet doors
- Lights off/dimmed in corridors & bays & station
- QUIET Signs on doors
- Penlights/torches to monitor obs
- Ensure ward is appropriate temperature
- Spare blankets available
- Warm drinks like milk, cocoa, decaffeinated drinks
- Soft closing lids for bins
- Bleeps set at an appropriate volume
- Extra pillows & positioning in bed optimized
Propofology.com
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A source of information only, not intended to replace advice of a medical doctor, nurse or healthcare practitioner.
