Get Me Some Sleep!

Maureen Larkin, for HealthLeaders Media, February 7, 2008

When's the last time you got a good night's sleep?

There are always excuses for why we didn't get our recommended eight hours of sleep: The game ran late. I couldn't put my book down. My child had a nightmare. My husband was snoring.

For most of us, missing a few hours of sleep means that we're just a bit grumpier in the morning, but a strong cup of coffee will usually get us back to our usual selves.

For those in the hospital--particularly the ICU--sleep is crucial, and an article in USA Today this week tells us that being a patient in the ICU isn't particularly restful.

ICU patients--because of their conditions--are checked on and visited by nurses and other hospital staff members much more often than those in regular hospital units. They're hooked up to machines that have alarms and beep to notify caregivers when they're not working properly, or have to be reset. Many ICU patients are on pain controlling drugs like morphine that make it hard to sleep, the article says.

The result is patients drifting in and out of sleep--not reaching the deep levels of sleep that promote healing--says, "Quantity and Quality of Sleep in the Surgical Intensive Care Unit: Are Our Patients Sleeping?" published in the December 2007 issue of The Journal of Trauma: Injury, Infection and Critical Care.

The study was led by Randall Friese, MD, of the University of Texas Southwestern Medical Center. It studied the sleep patterns of 16 intensive care patients at Parkland Memorial Hospital in Dallas. It suggests that hospitals examine their intensive care units and assess whether providing patients with more comfortable, home-like rooms, removing unnecessary medical equipment and adjusting light levels will help patients get more of the restful sleep they need to recover.

As we get ready for HCAHPS, a quiet hospital atmosphere is a topic that many have tried to tackle. Many hospitals have engaged nurses and other caregivers in efforts to keep hallways quiet and limited the number of overhead pages that happen during the nighttime hours. But have you considered those necessary interruptions--the medication-giving, blood-pressure taking visits--could be preventing them from getting the good, deep sleep they need to heal?

As Quality Leaders, we should be thinking about how much good sleep our patients are getting--whether it be in the intensive care unit or otherwise. We know that it is in our organization's best interest to get patients well in as little time as possible--keeping costs low and quickening the turnaround of hospital beds.

Going back to HCAHPS, we also want to make sure that our patients are answering the survey in the best frame of mind. Remember that grumpy feeling I mentioned earlier? If a patient leaves your hospital feeling sleep deprived and not quite healed, it's likely they'll remember that when they record their impressions of your hospital--particularly when the survey asks about the area surrounding the patient's room being quiet at night.

Good, quality sleep is important for all of us--but particularly so for those recovering from an illness and trying to heal. What does your hospital do to ensure a healing environment for its patients? I'd love to hear about it.

Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at
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