Traditionally, hospitals schedule nighttime activities around their healthcare workers, rather than their patients. Checking vitals, drawing blood and other necessary actions are typically aligned with shift changes or morning rounds. All patients might receive the same number of check-ins per night, regardless of medical need, meaning even those with less serious conditions are being disturbed nearly every hour.
According to a 2013 study published in JAMA Internal Medicine, about half of all patients woken up for vitals checks probably don’t need to be. Further, the study suggests unnecessarily waking patients may contribute to bad patient results and dissatisfaction, and could increase the odds of patients having to come back to the hospital.
With more and more hospitals looking to improve ratings and patient outcomes, some are re-evaluating how they function at night. As a recent article published by Kaiser Health News reports, many healthcare professionals are pushing for hospitals to actively take steps to improve patient sleep – from reducing nighttime check-ins to better coordinating the administration of medicines so that patients can benefit from quality rest.
What Disrupts Sleep and What are the Dangers?
In an effort to determine what hospital occurrences are most disruptive to patients getting a good night’s sleep, Dr. Jeffrey Ellenbogen, sleep medicine chief at Massachusetts General Hospital, conducted a study in 2012. The study found that although sounds like toilets flushing and people speaking loudly woke participants, electronic sounds, such as beeping from IV machines, were most likely to arouse patients from sleep, even when the noise wasn’t much louder than a whisper.
Although the study volunteers were only temporarily aroused, research shows that their heart rates increased as much as 10 beats a minute. For actual patients—particularly those who are older and frailer—who are awakened throughout the night, this constant disturbance can contribute to conditions such as high blood pressure, depression, memory problems and a weakened immune system.
Reducing Patient Disturbances
Facilities across the U.S. are taking steps to reduce the number of times patients are disturbed during the night. Steps which have been implemented include:
- Re-timing medication administration to match sleep schedules—in some cases prescriptions could be changed to drugs that can be given less frequently
- Rescheduling floor washing
- Implementing “quiet hours”
- Dimming lights
- Reducing the use of loud equipment
- Performing bedtime routines before 11 p.m. (take vital signs, give bedtime meds, ensure IV bag won’t empty at night, close patient door, etc.)
- Basing the frequency of check-ins on the seriousness of their condition
Does More Shut-Eye Lead to Faster Recovery?
Though there are few studies that expressly link quality of sleep with improved patient outcomes, many doctors say the connection is undeniable. The more rest a patient gets, the speedier their recovery process will be. As a result, waking patients unnecessarily could actually be putting them at risk.
With many hospitals receiving low scores on federal patient approval surveys regarding nighttime disturbances, it’s crucial to get to the root of the issue. Taking steps to reduce both nighttime noises and unnecessary awakenings can lead to better outcomes and more satisfied patients.
As research shows that many patients are awakened unnecessarily, taking the time to implement minor process changes may be well worth the effort.