0986 A Sleep Promotion Toolkit for Hospitalized Patients

• Published in: Sleep (New York, N.Y.) N.Y.), 2019-04, Vol.42 (Supplement_1), p.A397-A397
• Main Authors: Ye, Lichuan, Dykes, Patricia
• Format: Article
• Language: English
• Subjects: Collaboration; Hospitalization; Patients; Qualitative research; Sleep
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsz067.983

Introduction Inpatient sleep disturbance has been linked to clinically relevant and detrimental outcomes such as delirium and falls. Routine assessment, open dialogue, collaborative care planning, and tailored interventions, are key to patient-centered care to improve sleep for hospitalized patients. Interventions using health information technology hold potential to address these key issues of inpatient sleep promotion. This project aimed to inform the development of a sleep promotion toolkit (SLEEPkit) for hospitalized patients by conducting iterative refinement and pilot evaluation. SLEEPkit was designed as a downloadable application assessed from a smart phone or iPad device by patients. Starting from a valid self-assessment for sleep and its disturbing factors during the previous night, the SLEEPkit can generate personalized tips to address the patient’s specific need for sleep. Methods Qualitative methods within a standardized iterative participatory approach by working with stakeholders supported the refinement of the SLEEPkit. A randomized control trial was conducted to evaluate the effectiveness of SLEEPkit on patient sleep assessed by the PROMIS Sleep Disturbance and the actigraph. Semi-structured interviews were conducted to seek feedback on SLEEPkit focused on perceived usefulness, ease of use, user control, implementation, and maintenance. Results A total of 126 hospitalized patients (48.4% females, 6.3% Hispanics, 71.4% White) from oncology (26.2%) or medical-surgical units were randomized to use SLEEPkit or receive usual care for their sleep during hospitalization. No statistical differences were observed in changes in the PROMIS Sleep Disturbance T score (-0.1±10.3 vs. 1.1±11.3, p=.585) or in the actigraph measured average total sleep time (5:52±1:58 vs. 6:17±2:10, p=.311) and awakenings (31.4±17.9 vs. 31.1±13.5, p=.931) between groups. Overall patients and clinicians perceived that SLEEPkit empowered patient and supported patient-centered care and patient-clinician collaboration of sleep promotion. Conclusion This pilot investigation informed further development of the SLEEPkit and laid the groundwork for making inpatient sleep promotion effective and feasible. Future work on SLEEPkit should optimize user engagement, add clinician interface, and promote sleep at both unit and individual levels. Support (If Any) This project was supported by grant number R21HS024330 from the Agency for Healthcare Research and Quality.