Question

Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply.) A. Give patients a cup of coffee 1 hour before bedtime. B. Plan vital signs to be taken before the patients are asleep. C. Turn television on 15 minutes before bedtime. D. Have patients follow at-home bedtime schedule. E. Close the door to patients' rooms at bedtime.

Short answer

Appropriate nursing interventions to promote sleep for hospitalized patients include B. Plan vital signs to be taken before the patients are asleep, D. Have patients follow at-home bedtime schedules, and E. Close the door to patients' rooms at bedtime.

Step-by-step solution

Identify interventions that promote sleep

Review each option and determine if it is likely to promote a restful environment conducive to sleep. Consider common sleep hygiene recommendations and the impact of the hospital environment on sleep.

Evaluate each option

A. Caffeine is a stimulant, which can disrupt sleep. B. Taking vital signs before sleep can reduce disturbances at night. C. Televisions can stimulate the brain and disrupt sleep if used right before bedtime. D. Following a familiar routine can promote sleep. E. A quiet environment, like a closed room, is more conducive to sleep.

Select appropriate interventions

After evaluating each option, choose the ones that are likely to help patients sleep better in a hospital setting.

Key concepts

Sleep Hygiene in Hospital

Sleep hygiene refers to a variety of practices that are necessary to have normal, quality nighttime sleep and full daytime alertness. In a hospital setting, promoting good sleep hygiene is particularly important because the environment can often be disruptive to patients' sleep.

Implementing practices like dimming lights in the evening, reducing noise levels, and maintaining comfortable room temperatures can significantly improve sleep quality. Another aspect includes minimizing interruptions, for example, by synchronizing medication rounds or assessments with the patients' sleep schedule when possible. Encouraging patients to engage in relaxation techniques like deep breathing or meditation before bed can also be beneficial.

Patients are encouraged to bring personal items like pillows or photographs to make the hospital environment feel more like home. This can help support the internal cues that signal it's time for sleep, reinforcing their regular sleep-wake cycle.

Nursing Interventions for Sleep

Nursing interventions aim to create a restful environment and can include a wide range of activities tailored to individual patient needs. Important interventions may include:

• Planning care activities to minimize sleep disruptions. For instance, clustering care activities together and performing them earlier in the evening can avoid waking the patient multiple times.
• Encouraging patients to adhere to their at-home bedtime routines when possible, as familiarity can promote comfort and relaxation.
• Ensuring the door to a patient's room is closed at bedtime to reduce light and noise from the hallway, thereby creating a quieter, more peaceful environment.
• Teaching patients about the impact of diet and exercise on sleep, such as avoiding caffeine and large meals before bedtime.
• Providing resources like sleep masks or earplugs to block out unwanted light and noise.

Each of these nurse-led interventions is designed to tackle the challenges to sleep that hospitalization can present and aligns with broader sleep hygiene principles.

Hospital Routine and Patient Sleep

The hospital routine is built around the care and monitoring of patients, but it often doesn't align with normal sleep patterns, which can lead to sleep disturbances. Adapting the routine to support patients' sleep involves adjustments such as:

• Scheduling vital signs to be taken before patients are asleep, thus reducing nighttime awakenings.
• Reviewing medication times to ensure that stimulants or diuretics are not given in the hours leading up to bedtime.
• Adjusting the timing of rounds and other necessary interruptions to preserve the patients' sleep as much as possible.

It is also valuable for staff to educate patients on the importance of sleep and the potential impact of hospital routines, empowering them to advocate for adjustments to their care that could improve sleep.