Background: Overnight vital sign assessment can disrupt sleep in the hospital and may be unnecessary in clinically stable patients. However, providers may not feel comfortable determining which patients can safely forego overnight vitals. We studied the effect of a clinical decision support (CDS) tool embedded in the electronic health record (EHR) that automatically identified clinically [...]

Background: Interventions to improve inpatient sleep rely on the ability to objectively quantify sleep; however existing methods of measurement (wrist actigraphy and patient survey) are resource intensive and impose a burden on patients. To overcome these barriers, we developed “sleep opportunity” (SLOP), a surrogate metric for sleep derived solely from the electronic health record (EHR). [...]

Background: Rest is critical to healing, yet a child’s sleep during an inpatient hospital admission is often disrupted. One such disruption is oral medication administration, which is commonly scheduled around the clock (q6h, q8h, q12h) by default, despite comparable efficacy during waking hours. Previous studies suggest that flexible medication times help inpatients sleep longer and [...]

Background: Obstructive sleep apnea (OSA) is defined as a sleep disorder marked by pauses in breathing of 10 seconds or more causing unrestful sleep and accompanied by loud or abnormal snoring, daytime sleepiness, irritability, and depression. According to the National Sleep Foundation, more than 18 million Americans have OSA, 80% of whom are undiagnosed. The [...]

Background: Overnight disruptions in sleep during acute care hospitalizations contribute to lower patient satisfaction, higher risk of delirium, and potentially, increased length of stay. One primary offender of quality sleep is high frequency collection of vital signs during overnight hours. Protocols for reduction in collection of overnight vital signs have been successfully implemented at other [...]

Case Presentation: A 16 y/o male presented with an acute onset of palpitations, generalized chest pain, and rash (Figure 1). In light of recent camping exposure and targetoid lesions compatible with erythema chronicum migrans (ECM), Lyme disease was suspected. An EKG demonstrated 1st degree AV block with a PR interval of 384 msec. Echocardiogram and [...]

Background: Overnight vital sign assessment can disrupt sleep in the hospital and may be unnecessary in clinically stable patients. However, providers may not feel comfortable determining which patients can safely forego overnight vitals. We studied the effect of a clinical decision support (CDS) tool embedded in the electronic health record (EHR) that automatically identified clinically [...]