1. Effectiveness of SIESTA on Objective and Subjective Metrics of Nighttime Hospital Sleep Disruptors
- Author
-
Jacqueline Ramos, Babak Mokhlesi, Vineet M. Arora, Jeanne M. Farnan, Kristen L. Knutson, Samantha Anderson, Shannon K. Martin, Mary Ann Francisco, David O. Meltzer, William Marsack, Jay S. Balachandran, Cynthia LaFond, Andres Valencia, Edward Ki Yun Leung, Nolan R Machado, Nimit Desai, Ambrosio Tuvilleja, and Stephenie Blossomgame
- Subjects
Male ,medicine.medical_specialty ,Leadership and Management ,Vital signs ,Assessment and Diagnosis ,Vte prophylaxis ,Nursing Staff, Hospital ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Surveys and Questionnaires ,Patient experience ,medicine ,Humans ,030212 general & internal medicine ,Care Planning ,Inpatients ,business.industry ,Health Policy ,General Medicine ,Focus Groups ,Middle Aged ,Hospitals ,Siesta ,Emergency medicine ,Sleep Deprivation ,Fundamentals and skills ,Female ,Sleep (system call) ,business ,Sleep - Abstract
We created Sleep for Inpatients: Empowering Staff to Act (SIESTA), which combines electronic "nudges" to forgo nocturnal vitals and medications with interprofessional education on improving patient sleep. In one "SIESTAenhanced unit," nurses received coaching and integrated SIESTA into daily huddles; a standard unit did not. Six months pre- and post-SIESTA, sleep-friendly orders rose in both units (foregoing vital signs: SIESTA unit, 4% to 34%; standard, 3% to 22%, P < .001 both; sleeppromoting VTE prophylaxis: SIESTA, 15% to 42%; standard, 12% to 28%, P < .001 both). In the SIESTAenhanced unit, nighttime room entries dropped by 44% (-6.3 disruptions/room, P < .001), and patients were more likely to report no disruptions for nighttime vital signs (70% vs 41%, P = .05) or medications (84% vs 57%, P = .031) than those in the standard unit. The standard unit was not changed. Although sleep-friendly orders were adopted in both units, a unit-based nursing empowerment approach was associated with fewer nighttime room entries and improved patient experience.
- Published
- 2019