Background: Sleep disruptions for routine care, such as vital sign assessments, are common during hospitalization and are associated with negative health outcomes and patient satisfaction. While higher risk patients may benefit from increased monitoring at night, the tradeoff is less obvious for lower risk patients. We hypothesized that assigning overnight vital sign assessment based on [...]

Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult for individual clinicians to determine which patients could safely forego overnight vital signs. Purpose: We developed a predictive algorithm designed [...]

Background: Sleep disruptions for routine care, such as vital sign assessments, are common during hospitalization and are associated with negative health outcomes and patient satisfaction. While higher risk patients may benefit from increased monitoring at night, the tradeoff is less obvious for lower risk patients. We hypothesized that assigning overnight vital sign assessment based on [...]

Background: Clinically stable inpatients may receive potentially unnecessary care, such as overnight vital sign assessment. Nighttime vital signs can disrupt sleep and adversely affect patient satisfaction and contribute to delirium. However, it may be difficult for individual clinicians to determine which patients could safely forego overnight vital signs. Purpose: We developed a predictive algorithm designed [...]

Background: Excessive daily routine laboratory testing for hospitalized patients is a contributor to poor hospital sleep, iatrogenic anemia, and excessive costs. Recommendations from the Choosing Wisely™ campaign specifically state to avoid sleep interruptions for routine care (American Academy of Nursing) and to avoid routine labs for stable patients (Society of Hospital Medicine). The purpose of [...]

Background: Rapid Response System (RRS) was designed as a safety tool for early detection and intervention of a deteriorating patient on a general floor in a hospital and Modified Early Warning System (MEWS) scores can be used to identify these patients. Obstructive Sleep Apnea (OSA) has been described as an independent risk factor for long [...]

Background: The 2011 AAP policy statement regarding recommendations for a safe infant sleeping environment included hospitalized infants, but unsafe sleep practices continue to be common in hospitalized infants. Safe sleep position compliance was observed to be low at Baystate Chidlren’s Hospital (BCH), as described in a prior abstract (http://abstract.staging.hospitalmedicine.org/abstract/improving-infant-safe-sleep-practices-in-the-inpatient-setting-using-qi-methodology/). Interventions designed to improve rates of [...]

Background: Sleep disturbance has negative impact on physical coordination, metabolism, cognitive performance, immune function, coagulation cascade, cardiac risk and is associated with an increased risk of falls in hospitalized patients. The number of adverse events related to falls is startling and it poses a major health risk for patients in acute care facilities. As the [...]

Background: Hospitalized patients are often disrupted at night for routine medical care, some of which is unnecessary. These sleep disruptions have implications for patient satisfaction, delirium, mobility, immune status, as well as hospital outcomes such as length of stay and readmissions. Interventions to improve inpatient sleep would benefit from the ability to objectively measure sleep, [...]

Background: With the increasing focus on patient experience over the last decade in American healthcare, it is not surprising that numerous interventions to improve sleep in the hospital setting have arisen. However, measuring sleep in the inpatient setting can be challenging. The majority of inpatient sleep studies have focused in the ICU, primarily using patient-reported [...]