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Reducing Nighttime Interruptions and Improving Sleep for Hospitalized Patients by Restructuring Nighttime Clinical

Minna E Holleck1, Kei Tikkanen2, Jürgen L Holleck3,4

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Restructuring hospital nighttime clinical workflow reduced sleep disruptions. This change decreased medication and vital sign checks, leading to better patient sleep quality and fewer interruptions during hospitalization.

Keywords:
disruptionshospitalnoisequality improvementsleep

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Area of Science:

  • Healthcare quality improvement
  • Patient experience research
  • Clinical workflow optimization

Background:

  • Nighttime sleep disruptions are a significant issue for hospitalized patients.
  • Poor sleep negatively impacts patient recovery and overall hospital experience.

Purpose of the Study:

  • To evaluate the effectiveness of a sleep-promoting nighttime clinical workflow.
  • To assess the impact of workflow changes on nocturnal sleep disruptions and patient sleep quality.

Main Methods:

  • A pre- and post-intervention survey study was conducted on a general medical ward.
  • The study involved hospitalized veterans (N=149 pre, N=99 post).
  • Key interventions included rescheduling 4 am blood pressure checks and altering subcutaneous heparin administration timing.

Main Results:

  • Medication administration disruptions decreased from 40% to 4% (p<0.001).
  • Blood pressure check disruptions decreased from 56% to 42% (p=0.033).
  • Fewer patients reported taking longer to fall asleep (39% vs. 25%, p=0.021) and waking more frequently (46% vs. 32%, p=0.036).

Conclusions:

  • Restructuring the nighttime clinical workflow significantly reduced sleep disruptions for hospitalized patients.
  • The implemented changes improved patient-reported sleep outcomes, including reduced interruptions and faster sleep onset.