Inpatient Sleep Improves With Adjustments to the EHR System
Adjusting the electronic health record (EHR) system may help hospitalists and nurses avoid waking inpatients throughout the night, in turn avoiding patient grogginess and falls the following day, according to results of a new study.1
The study, coined the Sleep for Inpatients: Empowering Staff to Act (SIESTA), was conducted in two 18-bed general medicine units from March 2015 to March 2016. In all, 1083 general medicine participants were admitted either to the SIESTA-enhanced unit or to a nearby standard hospital unit.
IF YOU LIKE THIS, READ MORE...
Sleep Issues Are Common in Hospitalized Patients
Sleep Quality, Metabolic Link May Surprise You
Nurses and doctors in the SIESTA unit were given a 20-minute presentation about the consequences of in-hospital sleep deprivation and were also taught how to use the sleep-friendly tools in the computer system. Nurses in the SIESTA-enhanced unit received additional coaching to advocate for patients with physicians in that unit.2
In addition, electronic “nudges” through the participants’ EHRs forwent waking the patient in order to limit nighttime disruptions, including to measure vital signs or to administer nonurgent medications.
While sleep-friendly orders were adopted in both units, participants in the SIESTA unit reported a 44% decrease in nighttime room entries, as well as improved patient experience as per the national quiet-at-night patient experience measure.
The SIESTA program significantly increased decisions to forego nighttime vital signs every 4 hours (from 4% to 34%) and sleep-friendly timing of nighttime medications (from 15% to 42%).
In fact, patients noted 4 times fewer disruptions due to medications and 3 times fewer disruptions due to routine vital signs.
—Colleen Murphy
References:
1. Arora VM, Machado N, Anderson SL, et al. Effectiveness of SIESTA on objective and subjective metrics of nighttime hospital sleep disruptors. J Hosp Med. 2019;14(1):38-41. doi:10.12788/jhm.3091.
2. SIESTA project reduces inpatient sleep interruptions [press release]. Chicago, Il: University of Chicago medical Center; January 8, 2019. https://www.uchicagomedicine.org/forefront/patient-care-articles/2019/january/siesta-project-reduces-inpatient-sleep-interruptions. Accessed January 8, 2019.