Background: Although sleep is critical to recovery from acute illness, hospitalization is far from restful. Our prior work has demonstrated that hospitalization is a period of acute sleep loss for patients, nighttime noise levels and other unnecessary disruptions in hospital rooms often exceed safe levels, and hospital sleep loss is associated with poor health. Additionally, given the very high prevalence of sleep-disordered breathing among hospitalized patients, hospitalization is a ‘missed opportunity’ to screen patients for sleep disorders so that patients can receive optimal timely treatment.
Purpose: Our goal was to develop, implement and evaluate an innovative educational program, SIESTA (Sleep for Inpatients: Empowering Staff to Act), designed to prepare hospital staff to assist patients in obtaining better sleep in hospitals and recognize the importance of screening for sleep disorders
Description: The SIESTA education includes a trigger video vignette on common sleep disruptions that patients experience when getting sleep, and the resulting risks that they may face. In addition, the learners view a brief screencast that educates staff on safe practices for patients sleeping in the hospital as well as screening for sleep disorders. We also distributed several tools (including a pocket card with the STOP-BANG questionnaire and tape measure pen) to help learners screen their patients for sleep disorders, create a better environment for patients to sleep and to refer patients for sleep studies if they were at risk. The SIESTA program was piloted with 21 learners (14 nurses and 7 residents in Spring 2014). While all residents stated they were confident in their ability to screen for Obstructive Sleep Apnea (OSA) and 86% felt it was their responsibility to screen inpatients for sleep disorders, none could correctly identify a tool to screen for OSA and only 57% correctly identified risk factors for OSA. After the module, nurse confidence in ability to screen for OSA increased from 36% to 92%. Before the module, few residents (29%) and nurses (36%) were satisfied with the training they received on screening patients for OSA. After the module, residents and nurses (100%) reported the scenarios in the video were realistic, that the module was useful and effective, and they will change their behavior as a result of the exercise. Referrals increased by 89% following the pilot of the SIESTA education and patient diagnosis of OSA increased by 66%.
Conclusions: Hospitalization represents a missed opportunity to screen patients for sleep disorders. Although hospital staff think that screening for sleep disorders is important, they lack ability to do so. All learners agree that the SIESTA education was useful and would change their behavior regarding screening for sleep disorders. Future work will scale up SIESTA and examine the impact on patient sleep and staff behavior.
To cite this abstract:Spampinato L, Eberle B, Balachandran J, LaFond C, Wells T, Farnan J, Saathoff M, Mokhlesi B, Arora V. Siesta (Sleep for Inpatients: Empowering Staff to Act): A Pilot Study. Abstract published at Hospital Medicine 2015, March 29-April 1, National Harbor, Md. Abstract 104. Journal of Hospital Medicine. 2015; 10 (suppl 2). https://www.shmabstracts.com/abstract/siesta-sleep-for-inpatients-empowering-staff-to-act-a-pilot-study/. Accessed June 25, 2019.