Deep sleep and beeps II: Sleep quality improvement project in general surgery patients.

Autor: Allen RW; Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH. Electronic address: robertwaldoallen@gmail.com., Shaw RD; Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH., Burney CP; Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH., Newton LE; Geisel School of Medicine, Dartmouth College, Lebanon, NH., Lee AY; Geisel School of Medicine, Dartmouth College, Lebanon, NH., Judd BG; Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH; Geisel School of Medicine, Dartmouth College, Lebanon, NH; Sleep Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH., Ivatury SJ; Department of Surgery and Perioperative Care, University of Texas Dell Medical School, Austin TX.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2022 Dec; Vol. 172 (6), pp. 1697-1703. Date of Electronic Publication: 2022 Oct 28.
DOI: 10.1016/j.surg.2022.09.013
Abstrakt: Background: Poor sleep leads to poor health outcomes. Phase I of our sleep quality improvement project showed severe sleep disturbance in the ward setting. We implemented a novel PostOp Pack to improve sleep quality.
Methods: Patients underwent elective, general surgery procedures. Fitbit trackers measured total sleep time. Patients completed the inpatient Richards-Campbell Sleep Questionnaire, which combines 5 domains into a cumulative score (0-100). Patients completed the outpatient Pittsburgh Sleep Quality Index preoperatively and postoperatively. Patients received the PostOp Pack, which included physical items and a sleep-protective order set to reduce nighttime awakenings. Patients from phase I served as the historical control. The primary outcome was the percentage of patients with Richards-Campbell Sleep Questionnaire total sleep score ≥50. The secondary outcomes included the mean Richards-Campbell Sleep Questionnaire domain scores and Fitbit total sleep time.
Results: A total of 49 patients were compared with 64 historical controls. The percentage of patients with a total sleep score ≥50 was significantly higher in patients receiving a PostOp Pack versus historical control (69% vs. 44%, difference 26%, 95% confidence interval 6.1-45%, P = .01). The mean Richards-Campbell Sleep Questionnaire Total Sleep Score was significantly higher in patients with a PostOp Pack (62 vs 49, mean difference 13, 95% confidence interval 6-21, P ≤ .01). The PostOp Pack Richards-Campbell Sleep Questionnaire domain scores were significantly higher in various areas: Sleep Latency (68 vs 49, P ≤ .01), Awakenings (56 vs 40, P = .01), Sleep Quality (61 vs 49, P = .02), and Noise Disturbance (70 vs 59, P = .04). Of all patients, 92% would use PostOp Pack again in a future hospitalization. No patients had a failure to rescue event with PostOp Pack. The mean total sleep time was significantly improved with PostOp Pack on night 1 (6.4 vs 4.7 hours, P = .03).
Conclusion: The PostOp Pack improves inpatient sleep quality and is safe.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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