Sleep quality is affected at decibel levels over 42 dBA, yet the majority of hospital wards at night have been shown to consistently exceed these levels, this impacts on every aspect of care. Staff conversation is typically > 50% of the reported cause and cited as the most disruptive by patients and carers.1
The Great North Children’s Hospital is a large tertiary hospital in the Northeast of England, with two PICU and ten paediatric wards. We describe a sleep improvement programme developed over 2 years that incorporated the Southampton Sleep Health in Hospital protocol2 described by Professor Hill, with individual ward sleep champions and additionally SoundEARS installed by the nursing station on every ward.
We developed a multidisciplinary team of sleep champions including medical staff sleep physiologists, nursing staff, healthcare assistants and play specialists. As a larger group we have identified noise as a key area for improvement.
After enrolling in the Sleep for Health in Hospital project and attending a training workshop; training was cascaded across the wards and across the multidisciplinary teams. Specific, targeted education was developed for staff with short educational presentations delivered in-situ on wards but also to senior ward sisters and directorate managers. Webpages about ‘normal’ sleep for younger and older children were embedded within trust intranet for staff and parents. Highlighting the importance of undisturbed sleep led to changes in the timing of overnight observations, reducing the number of medications being given overnight and clustering interventions (bundling care).
SoundEARS were installed on the wards as a visible reminder to patients, their families, and staff about the importance of reducing noise overnight. Mean noise levels were initially logged over two weeks. Showing night staff noise levels above the WHO recommended levels for health was shown to modify behaviour and significantly reduce night noise over time.
Jue K, Nathan-Roberts D. How Noise Affects Patients In Hospitals. Proceedings of the Human Factors and Ergonomics Society 2019 Annual Meeting 2019. p1510–1514.
Sleep for Health in Hospital. Sleep for Health in Hospital Programme (SHH). Available at: Sleep for Health in Hospital Programme (SHH) - PAEDIATRIC INNOVATION, EDUCATION & RESEARCH NETWORK (piernetwork.org) Accessed: May 2023
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