Postponing nurses’ morning rounds may improve patients’ sleep

Non-pharmacological interventions may be effective in improving Sleeps A recent study found that personal hygiene with medical and surgical patients.

patients in hospital Settings often indicate difficulties sleeping, with many negative side effects associated with them. In addition to impaired cognitive performance and mental health, inadequate sleep can affect the risk of falls, delayed wound healing, increased insulin resistance, and immunosuppression.

Thus, improving sleep for hospital patients was viewed as necessary and relevant by the researchers in this study led by Eva S. Department of Internal Medicine.

“Common pharmacological interventions to improve sleep are the use of benzodiazepines and melatonin,” Van den Ende and colleagues write. However, there is insufficient evidence that these drugs work in hospitalized patients. A systematic review and meta-analysis reported that the benefits often do not outweigh the risks of the drugs.”

As a result of these risks and the potential for adverse outcomes, non-pharmacological intervention has been viewed as an important topic of interest.

Search and methods

The researchers recruited a total of 374 patients for the nonrandomized trial, including all if they were admitted to one of the three participating hospital wards, had spent one night in the hospital, and were 18 years of age or older.

The research team developed a sleep profile containing an overview of sleep hygiene tips and tricks, as well as tools such as decaffeinated tea, earplugs, aromatherapy oil, soft music response codes, mindfulness, and audio-guided imagery. The researchers also provided training sessions for nurses on the importance of sleep, and quizzes were designed to test knowledge after the session.

They also changed medications and vital sign checks to slightly later times. The patients were given a sleep recording bracelet, to detect movement in order to measure sleep. Patients will fill out questionnaires regarding their previous nights’ sleep, and interrogate before 11 am to allow maximum reduction of recall bias.

The investigators measured the participants’ sleep through the art of writing as well as the Outcome Measurement Information System reported by the Dutch-Flemish patient. In addition, additional patient outcomes evaluated were patient-reported sleep disturbance factors and their use of available sleep-promoting tools.


The intervention group was 152 patients and the control group was 222, and the mean age was 65 years. In total, 331 participants were included in the overall assessment. For the intervention group, the total sleep time was 40 minutes longer than the control group due to a 30 minute wake-up time delay. However, sleep quality was not significantly different with either group.

Delays in final wake-up time and postponement of morning nursing rounds were positively received by hospital staff, and were maintained even after completion of the study. The researchers found no significant differences in nurses’ distribution of potential sleep-improving medications or sleep-disturbing medications, and recommended this change in time, citing its benefits to inpatient sleep and general simplicity.

The investigators also found that underlying sleep-disturbing factors such as pain, ambient light and noise, bathroom visits, and staff waking of patients were reported. They also found that among the sleep aids provided, sleep masks and earplugs were the most used (16% and 12%, respectively). A significant decrease in nocturnal vital sign examinations was observed (intervention: 11%; monitoring: 54%; s <.001).

“Future research could focus on whether comfortable sleep masks and earplugs will increase popularity and whether there are alternatives to attenuating external stimuli at a patient level without completely isolating the patient from the outside world (such as a dome designed to reduce exposure to sound and light),” they wrote.

this article,”Evaluation of non-pharmacological interventions and sleep outcomes in hospitalized medical and surgical patients/Non-randomized controlled trial‘online at JAMA Network is open.