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Improving Hospitalized Children's Sleep by Reducing Excessive Overnight Blood Pressure Monitoring.
David J Cook1, Vineet M Arora1,2, Michael Chamberlain1
1Pritzker School of Medicine, The University of Chicago, Chicago, Illinois; and.
Pediatrics
|August 21, 2020
Summary
Hospitalized children often experience disrupted sleep due to frequent blood pressure (BP) monitoring. This pilot study reduced overnight BP checks, improving sleep duration and decreasing disruptions for pediatric inpatients.
Area of Science:
- Pediatric Hospital Medicine
- Sleep Science
- Health Informatics
Background:
- Sleep is crucial for healing but frequently disturbed in hospitalized children.
- Overnight blood pressure (BP) monitoring is a common, yet often unnecessary, disruptor for pediatric inpatients.
- Improving sleep quality is a key goal for pediatric patient care.
Purpose of the Study:
- To decrease unnecessary overnight BP monitoring in pediatric inpatients.
- To enhance sleep duration and quality for hospitalized children.
- To evaluate the impact of an intervention on sleep and BP monitoring practices.
Main Methods:
- Implemented clinician education and updated electronic health record (EHR) orders to facilitate forgoing overnight BP checks.
- Utilized validated patient-caregiver surveys to measure sleep duration and disruptions.
- Employed interrupted time series analysis and statistical process control for outcome assessment.
Main Results:
- Significantly increased the proportion of patients forgoing overnight BP monitoring by 50.7%.
- Observed a significant increase in sleep duration for patients over 2 years old.
- Reduced nighttime clinical disruptions by 19% with no reported adverse events.
Conclusions:
- A pilot intervention combining EHR modifications and education effectively reduced overnight BP monitoring in pediatric inpatients.
- The study demonstrated a safe and significant improvement in pediatric inpatient sleep.
- This approach offers a cost-effective strategy to enhance patient recovery and well-being.
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