Audit of pain and sleep during sleeping hours

This joint audit between nursing and medical staff examines the quality of sleep experienced during the night and the degree to which pain is controlled in a specialist palliative care unit. Patients and nurses independently completed short questionnaires incorporating categorical rating scales for pain and sleep. Patients' perceptions were directly sought. Nurses were good at assessing whether patients slept well and also whether they were pain free. However assessment was less accurate in judging the degree of pain when present or quality of sleep when poor. Areas to improve pain control and sleep were identified. This audit methodology has the potential to provide outcome measures of quality of palliative care not only for the individual palliative care provider but also wider purchaser and provider bodies.