Quasi-experimental, Nonrandomized Initiative to Minimize Sleep Disruptions among Hospitalized Children

Area of Science:

• Pediatric Hospital Medicine
• Sleep Science
• Healthcare Quality Improvement

Background:

• Hospitalized children frequently experience sleep disruptions.
• Caregivers identify overnight vital signs (VS) as a major cause of these disruptions.
• A need exists to improve pediatric sleep quality during hospitalization.

Purpose of the Study:

• To decrease caregiver-reported sleep disruptions in hospitalized children by 10% over 12 months.
• To implement and evaluate a modified VS frequency order.
• To assess the impact of the new VS protocol on patient sleep and safety.

Main Methods:

• Introduced a new VS order: 'every 4 hours (unless asleep between 2300 and 0500)'.
• Utilized an electronic health record (EHR) to track adherence to the new VS order.
• Measured caregiver-reported sleep disruptions as the primary outcome.
• Monitored adherence and rapid responses as process and balancing measures.

Main Results:

• Caregiver-reported sleep disruptions decreased significantly from 24% pre-intervention to 8% post-intervention (P < 0.001).
• Overnight blood pressure readings were substantially reduced with the new VS frequency (36% vs. 87%, P < 0.001).
• No adverse safety events were associated with the intervention.

Conclusions:

• A new vital signs frequency protocol was safely implemented in a pediatric hospital setting.
• The intervention successfully reduced overnight blood pressure monitoring.
• The study demonstrated a significant reduction in sleep disruptions for hospitalized children.