[A Quality Improvement Project to Enhance Sleep Quality Among Nursing Home Residents]

Poor sleep quality, highly prevalent among nursing home residents, is associated with accelerated functional decline, increased risk of falls, and compromised safety and quality of life. A baseline audit at our facility revealed that 77.5% of the residents experienced sleep disturbances, with a mean overall sleep satisfaction score of 3.8 (out of 5). Factors found to influence sleep disturbance among the residents included the absence of a standardized sleep-assessment protocol, interruptions in nighttime care routines, and environmental conditions such as noise and inappropriate lighting.

A project was developed and implemented to reduce the prevalence of sleep disturbance among the residents and improve their nighttime sleep satisfaction.

A standardized sleep-quality assessment pathway was developed and a multicomponent Good-Sleep Care Bundle was implemented targeting care routines, noise control, and lighting optimization. We concurrently launched a Daylight & Light-Activity program that combined scheduled bright-light therapy with low-intensity daytime activity, lighting fixture repositioning, and the mandating of nighttime illumination thresholds.

After implementation, the proportion of residents with poor sleep decreased from 77.5% to 52.5%, and the average nighttime sleep-satisfaction score improved from 3.8 to 4.5, meeting the predefined targets of this project.

The developed program, a standardized assessment pathway coupled with a multicomponent, non-pharmacological care bundle, effectively improved sleep quality and nighttime satisfaction in the residents, enhancing their care experience and quality of life. The program is feasible, low risk, and scalable for routine implementation in nursing homes.