Don’t Make a Peep, Patients Need to Sleep!

Massachusetts General Hospital (Boston, Massachusetts)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Added to Collection

Project Topic

Quiet at night

Hospital Unit

Acute Medical Telemetry Unit – White 11

CSI Participants

Katrina Cabral, BSN, RN
Sandra Kelly, BSN, RN
Sue Wood, MSN, RN, ANP-BC

Project Goals/Objectives

  1. To improve unit Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score for “Quiet at night” from 42% to 52% (2019 target = 53.6%)
  2. To determine the most common disturbances to quality sleep on White 11
  3. To change the culture of White 11 to one which recognizes the importance of sleep and of practices to promote sleep

Project Outcomes

  1. Determined that roommates (26%), monitors (15%) and bed alarms (8%) accounted for 49% of noise complaints
  2. Improved the practice of approximately 95% of nurses to reduce noise at night

Project Overview

White 11’s “Quiet at night” HCAHPS score was among the lowest in the hospital. This meant our patients were not getting the quality sleep needed to heal and our hospital was losing reimbursement funds because it did not meet national target goals.

Our floor did not have a formal program aimed at improving patient sleep or our HCAHPS scores for quietness at night, so our CSI team researched the benefits of sleep and educated staff on the importance of patients’ sleep. We initiated daily huddles to determine what was causing noise on our floor and how to reduce it.

Once the causes were known, we introduced many interventions. We continually encouraged staff to implement these interventions as appropriate and rewarded them for their efforts. We developed a sleep menu and a sleep kit, which each patient received on admission. We surveyed patients after discharge and requested feedback to determine the most common disruptions to sleep on our floor.

Six months later, we continue the brief huddles and make additional changes to promote sleep where possible. A staff survey indicates that we have changed the culture on our floor to one that fosters practices to promote sleep. Our sleep kit has also been used by other floors in the hospital.

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The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.