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Implementation Outcomes for the SLUMBER Sleep Improvement Program in Long-Term Care.

Joshua Chodosh1, Mary Cadogan2, Abraham A Brody3

  • 1Department of Medicine, New York University Grossman School of Medicine, New York City, NY, USA; Medicine Service, VA New York Harbor Healthcare System, New York City, NY, USA.

Journal of the American Medical Directors Association
|March 17, 2024
PubMed
Summary
This summary is machine-generated.

Implementing a mentored sleep program in nursing facilities is feasible. This study shows that engaging staff and using text messages can improve resident sleep quality and the facility environment.

Keywords:
Sleepdepressionimplementationquality improvementskilled nursing facilities

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Area of Science:

  • Gerontology
  • Nursing Science
  • Implementation Science

Background:

  • Sleep disturbances are prevalent in nursing facility residents, impacting their quality of life and health outcomes.
  • Effective interventions are needed to improve sleep quality in this vulnerable population.

Purpose of the Study:

  • To describe the implementation of a mentored staff-delivered sleep program (SLUMBER) in nursing facilities.
  • To evaluate the feasibility and engagement strategies of the program.

Main Methods:

  • A modified stepped-wedge, unit-level intervention was implemented in two New York City nursing facilities.
  • Expert mentors delivered webinars, workshops, and text message 'sleep pearls'.
  • The integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework was used.

Main Results:

  • The SLUMBER program was implemented across 5 units in 2 facilities over 3-4 months.
  • Staff attendance averaged over 3 sessions per individual, with approximately 65% participation per session.
  • Text messaging proved effective for engagement, reinforcement, and attendance.

Conclusions:

  • Implementing a multicomponent sleep program with staff, leadership, residents, and families is feasible for improving the nursing facility sleep environment.
  • Building trust through presence and empathy, alongside reinforcement mechanisms like text messages, was crucial.
  • A train-the-trainer model could enhance scalability and sustainability for future implementation.