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Nonpharmacological interventions to promote sleep and rest among hospitalized pediatric patients in general pediatric
Sarah McGraw1,2, Michelle Palokas1,2, Lee Harbour3,2
1School of Nursing.
Insights
Implementing nonpharmacological interventions significantly improved pediatric sleep practices in hospitals, increasing compliance by 78%. This study highlights the effectiveness of multifaceted approaches for better patient rest and recovery.
Area of Science:
- Pediatric Nursing
- Sleep Science
- Healthcare Implementation Science
Background:
- Hospitalized children face numerous sleep disruptions like noise, pain, and care interruptions.
- Evidence supports multifaceted sleep promotion strategies to reduce sleep onset latency and nighttime awakenings.
- Noninvasive, low-cost strategies for promoting sleep and rest in pediatric patients are crucial for healing.
Purpose of the Study:
- To enhance adherence to best practices for nonpharmacological sleep and rest interventions in pediatric nonintensive care settings.
- To evaluate the impact of implementing evidence-based protocols and education on sleep promotion strategies.
Main Methods:
- Utilized the JBI Evidence Implementation framework for the project.
- Conducted baseline and follow-up audits of nurses and patients/caregivers regarding sleep promotion education and practices.
- Implemented targeted strategies including a sleep promotion protocol and multifaceted education for staff and families.
Main Results:
- Achieved 93% compliance with best practice post-implementation, a substantial increase from 15% at baseline.
- Identified baseline deficiencies in nurse education, protocol use, multifaceted approaches, and patient/caregiver education.
- Demonstrated significant improvements across all audited areas following intervention implementation.
Conclusions:
- Identified and addressed deficiencies in best practices for pediatric sleep promotion in general hospital wards.
- Implemented interventions proved beneficial in improving sleep and rest practices.
- Recommended further research on long-term intervention effectiveness and suggested post-implementation audits later in patient stays.
Objectives:
The aim of this implementation project was to improve compliance with best practice regarding nonpharmacological interventions used to promote sleep and rest in hospitalized pediatric patients in a nonintensive care setting.
Introduction:
Hospitalized children endure numerous hindrances to sleep and rest, including, but not limited to, noise, pain, anxiety, and interruptions for nursing care. Evidence suggests that a multifaceted approach to sleep promotion can reduce the length of time to sleep onset and the length of nighttime awakenings. It is widely accepted, however, rarely practiced, that proven, low-cost, and noninvasive strategies exist to promote sleep and restoration of hospitalized pediatric patients, which fosters healing and recovery.
Methods:
This project used the JBI Evidence Implementation framework. A baseline audit of 22 nurses' and 31 patients'/parents'/caregivers' receipt of education on strategies to promote sleep and rest was obtained via survey; baseline data were also obtained from nurses regarding whether or not a multifaceted approach to sleep promotion is utilized and/or if an evidence-based protocol regarding sleep promotion is in place. Targeted strategies, including a protocol and nurse/patient education of multifaceted approaches to sleep, were then implemented, and a follow-up audit of 25 nurses and 32 patients/caregivers was completed.
Results:
Overall, postimplementation audits revealed 93% compliance with best practice, a 78% increase from baseline audits of 15%. Baseline data revealed poor knowledge of and/or compliance with each of the four audit criteria: nurse education on strategies to promote sleep and rest, the use of an evidence-based protocol regarding sleep promotion, a multifaceted approach to sleep promotion, and patient and/or caregiver education regarding sleep promotion. Postimplementation data, however, showed improvement in each of these areas.
Conclusion:
Deficiencies in best practice recommendations for the promotion of sleep and rest in pediatric patients admitted to general wards were identified, interventions were implemented, and results were beneficial. Further investigation could be taken to assess the long-term effectiveness of interventions and/or sleep quality of patients while hospitalized. Moreover, postimplementation audits should be administered to parents near the end of their stay, after they have had time to implement optional interventions, if they choose.
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