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Do Patients Sleep Well in the Acute Rehab Setting?
Do Patients Sleep Well in the Acute Rehab Setting?
Do Patients Sleep Well in the Acute Rehab Setting?
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Video Transcription
Hi, my name is Shane Davis. Thank you for taking the time to check out our study on patient sleep quality in the acute rehabilitation setting. As you know, sleep is an important component of human recovery from illness and injury. The CWIB unit has sustained serious injury and will benefit from all measures that maximize recovery. Unfortunately, sleep is a notoriously difficult thing to achieve in the hospital setting due to factors such as noise, medication administration, nursing and physician checks, as well as general illness and discomfort. We set out to evaluate patient sleep quality in our acute rehab unit in comparison to the patient's perceived sleep in the acute hospital and at home. To do so, we administered a modified version of the Richards-Campbell Sleep Questionnaire, a validated survey that assesses patient sleep quality in the hospital setting. The survey was administered on admission to the acute rehab unit to assess patient sleep quality at home and in the preceding hospital stay, as well as on discharge from the acute rehab to assess sleep during their rehab admission. If you look to the far right, you can see a sample of the sleep questionnaire that we utilized, which uses a visual analog scale from 0 to 100 to assess patient sleep quality in the following domains. Sleep depth, time to fall asleep, number of awakenings, percent of time awake, and quality of sleep. These values were then averaged to create an overall sleep perception score. Additionally, we added a question regarding noise. Our results showed that patients reported significantly better sleep in all domains and overall in the acute rehab unit compared to the hospital, with the exception of percent of time awake. Patients also reported significantly better sleep depth, but worse noise in the acute rehab unit when compared to home. Similarly, patients reported better sleep in all domains and overall at home in comparison to the hospital, with the exception of percent of time awake. A visual illustration of these findings are shown in the box and whisker plots in the middle of this poster. The table on the bottom provides more information on what are common causes of sleep disturbances reported by patients in the acute rehab unit. As hypothesized, patients in the rehab unit reported better sleep quality than the acute hospital setting. There is reason that this might be the case. Patients in the rehab unit are less acutely ill and require less frequent monitoring with nursing checks, vital signs, lines, drains, and tubes. Additionally, physician rounds tend to be later in the morning, medications can be more commonly administered during waking hours, and daily routines more closely mimic those at home. Decreased noise in the rehab unit is also thought to be a contributing factor, as noise is known to negatively impact sleep quality. Surprisingly, patients were also noted to obtain sleep quality comparable to what they achieved at home, despite an increase in noise. This is the first study to our knowledge that assesses sleep quality in the acute rehab setting, providing information on how well this patient population sleeps, and sheds light on what might be ways of improving sleep quality in the future. Some ideas include promoting more quiet units, providing patients with simple sleep aids such as eye masks or earplugs, and avoiding unnecessary sleep disruption by modifying medication administration times, avoiding unnecessary nursing checks, and performing lab draws and physician rounds tailored to the patient's schedule.
Video Summary
This study examined patient sleep quality in the acute rehabilitation setting compared to the hospital and home. The researchers used a modified version of the Richards-Campbell Sleep Questionnaire to assess sleep quality in various domains. The results showed that patients reported better sleep in all domains and overall in the acute rehab unit compared to the hospital, with the exception of percent of time awake. Patients also reported better sleep at home compared to the hospital, except for percent of time awake. Noise was identified as a common cause of sleep disturbances in the rehab unit. Suggestions for improving sleep quality include promoting quiet units, providing sleep aids, and modifying medication administration and nursing checks to avoid unnecessary disruption.
Keywords
patient sleep quality
acute rehabilitation setting
Richards-Campbell Sleep Questionnaire
sleep disturbances
quiet units
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