Although sleep is imperative to biological function and of critical importance in the recovery process from acute illness, hospitalization is far from restful. Almost half of Medicare patients who have been hospitalized nationwide state that their hospital room was not kept quiet at night. Our prior work has demonstrated that hospitalization is a period of acute sleep deprivation for patients, nighttime noise levels in hospital rooms are often high, and that hospital noise levels are associated with clinically significant sleep loss. Or prior work has also demonstrated that this sleep loss is associated with higher morning blood pressure measurement. Furthermore, at the root of these sleep disruptions are modifiable factors, such as staff conversation and medical care interruptions. In addition to guarding against ongoing sleep loss in hospitalized patients, hospitalization represents a 'missed opportunity'to screen patients for sleep disorders and provide them with education regarding proper sleep hygiene. Given the very high prevalence of sleep disorders among hospitalized patients, routinely screening patients for potential sleep disorders can facilitate receipt of optial treatment and improved health for patients. Although experts agree on the need to optimize sleep in hospitals and improve screening for sleep disorders among hospitalized patients, no educational program to date has focused on training hospital staff to achieve this change. To address these concerns and improve sleep in US hospitals, we aim to develop, implement, and evaluate the SIESTA (Sleep for Inpatients: Empowering Staff to Act) educational program. We will draw upon the skills of a multidisciplinary group of faculty and consultants with expertise in clinical sleep, sleep research, educational theory, public health education outreach, continuing medical education, and e-learning. Together, our team will deploy a variety of innovative educational methods, which specifically align with the Kolb experiential learning cycle, which is designed to enable learners to reflect and put skills into practice. To evaluate the program's effectiveness, we will test the program at the University of Chicago and use the Kirkpatrick four levels of evaluation model, which specifies measurement of learner satisfaction, knowledge, behavior, and patient outcomes. Lastly, we will aim to spread this program through the NIH-CTSA supported LEARN (Learning Effectiveness and Research Network) of Chicago teaching hospitals, and use the RE-AIM model to test the spread and sustainability of this program. Dissemination will be achieved through traditional mechanism as well as novel partnerships with professional societies and industry.
The proposed education will aim to prepare hospital staff (physician and nurses) to address and improve sleep among hospitalized patients through (1) better screening for sleep disorders and sleep hygiene;and (2) optimizing the environment so patients can receive sleep. Using a team of multidisciplinary experts from sleep medicine, hospital care, and health education, we will build, implement, evaluate, and spread a multi- component educational program based on cutting-edge adult learning theory to promote behavior change.
|Calev, Hila; Spampinato, Lisa M; Press, Valerie G et al. (2015) Prevalence of impaired memory in hospitalized adults and associations with in-hospital sleep loss. J Hosp Med 10:439-45|
|Shear, Talia C; Balachandran, Jay S; Mokhlesi, Babak et al. (2014) Risk of sleep apnea in hospitalized older patients. J Clin Sleep Med 10:1061-6|