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God destined us to obtain salvation through our Lord Jesus Christ, so that whether we wake or sleep we might live with him. Patel J, Baldwin J, Bunting P, Laha S. The effect of a multicomponent multidisciplinary bundle of interventions on sleep and delirium in medical and surgical intensive care patients. Anaesthesia. 2014;69(6):540-9.
BBC iPlayer - Inside No. 9 - Series 1: 2. A Quiet Night In BBC iPlayer - Inside No. 9 - Series 1: 2. A Quiet Night In
Antiphon: Preserve us, O Lord, while waking, and guard us while sleeping, that awake we may watch with Christ, and asleep we may rest in peace. PRAYERS Collect Wilson C, Whiteman K, Stephens K, Swanson-Biearman B, LaBarba J. Improving the patient’s experience with a multimodal quiet-at-night initiative. J Nurs Care Qual. 2017;32(2):134-40. At the University of North Carolina Medical Center (UNCMC), a Magnet ®-recognized 803-bed level I trauma center, we receive impressive Hospital Consumer Assessment of Health- care Providers and Systems (HCAHPS) scores. However, patients’ responses to the question “During your hospital stay, how often was the area around your room quiet at night?” often fell short. Although specific sources of noise weren’t identified, two facts are certain: Noise levels in acute-care settings have increased significantly over the years, and sleep disturbance among hospitalized patients can impair healing and contribute to functional and psychological impairments. Based on these data, national attention on the role of sleep in health and well-being, and the fact that sleep quality is amenable to nursing intervention, the UNCMC division of nursing identified sleep promotion and noise reduction as annual goals. Evidence-based review
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translation: "The Traitor Dong Zhuo Secretly Harbours a Deposition Plan", from Romance of the Three Kingdoms HCAHPS Top Box scores improved on both units; one unit exceeded the 5% improvement goal at 90 days. Both units achieved a reduction in top sources of bothersome noise goals when resurveyed at 90 days, and they continue to work on improvement and sustainment. Nurses’ contribution
quiet night - Spanish translation – Linguee quiet night - Spanish translation – Linguee
Based on the interventions identified in the literature evidence tables, the team chose four—offering a sleep menu, offering warm water (shower or bath) at bedtime, replacing noisy equipment, and lowering staff voices—for PDSA cycles of improvement over several weeks. Sleep menu The project team established process measures to assess adherence to the interventions. Outcome measures included monthly HCAHPS Top Box scores on the quietness of hospital environment and the sources of noise survey scores. The team set a goal of 5% improvement in HCAHPS and a 20% decrease in bothersome sources of noise. Barnes CM, Drake CL. Prioritizing sleep health: Public health policy recommendations. Perspect Psychol Sci. 2015;10(6):733-7.
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A warm bath or shower before bedtime was impractical to implement on a broad scale in a hospital setting. However, EVS team members suggested a creative approach: Offer warm washcloths to the patients in the evening, which became part of the next experiment and PDSA cycle. Noise level Antiphon: Preserve us, O Lord,* while waking, and guard us while sleeping, that awake we may watch with Christ, and asleep we may rest in peace. The team’s completion plan included monitoring and maintaining individual action items, such as monthly meetings to report on current status and to compare current project metrics against preintervention HCAHPS scores. Insights
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