Shhhh: Silence is golden

Northwest UBTs are helping new moms and other patients get quality ZZZs

TUESDAY, FEBRUARY 12, 2008 :: By Jennifer Gladwell

Sleep and healing go hand in hand—but hospital stays are full of interruptions that can make quality rest elusive. To turn that around, two separate unit-based teams at Sunnyside Medical Center in the Northwest region are actively trying out ways to improve the environment and make sure their patients aren't sleep-deprived.

Research has shown that patients need rest to recuperate from illness. At Sunnyside, one team's primary challenge was to reduce the overall volume of noise. Another team made changes in their routines so that patients could have stretches of time that weren't uninterrupted by medical staff or visitors.

Keep the noise down

In one case, the staff members on the cardiac telemetry unit at Kaiser Sunnyside Medical Center were getting feedback from patients that noise was keeping them awake at night. The unit is one of the older ones in the hospital, and its hall is lined with an ice machine, beverage dispenser and supplies for patients. The hallway also happens to be a gathering spot for staff to chat and catch up on the latest news and information—which makes for added noise and traffic.

The unit-based team decided to address the problem. The staff created signs and posted them in the halls and added a sign outside the unit establishing a "quiet zone" from 11 p.m. to 7 a.m. They also have encouraged others to use an alternate hallway that is carpeted—instead of the main corridor outside patient rooms—when they are pushing carts, equipment, empty beds, and so on. In addition, staff members are reminding each other to keep conversations quiet.

Both patients and staff have noticed a significant improvement. On a scale of 1-10, the reported noise level dropped from 7-9 to 0-2. The 1 North UBT will work toward implementing this improvement project to all shifts.

Nap time for moms and babies

During the new nap-time hours on 2 South, the family nursing unit, the new motto is "Don't wake the baby!" (or the mom).

Using "plan, do, study, act," the four steps of the rapid improvement model to improve performance, the frontline team of health care workers decided to set aside a two-hour block of time that would be free from interruptions, so moms and babies could rest undisturbed. From 2 to 4 each afternoon, the new moms and babies on the unit don't have lab draws, dietary visits, provider visits, outside visitors or any other interruptions.

According to nurse manager Kathy Buhler, research shows that providing a block of uninterrupted time "not only improves patient satisfaction but improves breastfeeding as well." Dory Schutte, labor co-lead, is excited about working on the nap-time project, especially because "research shows that it's a good idea" for moms and babies.

The plan came about after the 2 South UBT decided to focus on customer service. In reviewing discharge surveys for their unit, they realized that patients were complaining about not getting enough rest because of frequent interruptions. They discussed in their team how they might solve this problem and decided to test the "nap time" period for two weeks.

During the trial, questions were added to their department discharge survey so the impact on patients can be assessed. And while the change isn't expected to impact other units in the hospital, the team realized communication was necessary. An email was sent to managers asking them to alert all staff to the change, while Janet Leigh, MD, physician lead for the unit-based team, let physicians know of the trial. Staff members are also communicating with families so they are aware of the benefit to mom and baby.

"We know rest and sleep are necessary for recovery from childbirth and for milk production," said Leigh, the assistant chief of obstetrics and gynecology. "This unit-based team project is addressing this need in an innovative way."

The team will assess the results and either implement the new process or make some changes and try again. In the meantime—please let the babies and moms sleep during nap time.