Dr. Nandita Kaza
Dr. Lucy Pickard Sullivan
Dr. Caroline Scott-Lang
The quality of sleep in paediatric inpatients has been shown to be poor and many hospitals have been demonstrated to have night-time environments which are not conducive to patients experiencing adequate sleep and rest during inpatient admissions.
The aim of this project was to use descriptive measures to describe sleep quality in parents and unwell children admitted to a general paediatrics ward in a tertiary London hospital and to identify barriers to adequate sleep amenable to quality improvement interventions.
Progress made: What have you learned from doing this?
This study used semi-structured interviews with parents who resided in hospital alongside their unwell children admitted to the ward. 20 families admitted to the ward sleeping in both open bays and private cubicles who had been admitted for at least one night in hospital were included. Interviews were conducted by an external member of staff (unaffiliated to the ward) and results were analysed using content analysis.
75% of parents experienced poor to average sleep quality while on the ward a majority felt that their sleep quality overnight affected daytime functioning with regards to emotional lability, difficulties with concentration, exhaustion and physical symptoms of tiredness. Similarly, 70% of children experienced poor sleep in hospital compared to when in their own homes and this manifested as daytime irritability, restlessness and lethargy. Barriers to sleep originated principally from ambient factors (lighting, noise and ventilation) and staff interventions. The interventions which we identified included using a welcome pack explaining ward etiquette, the use of sleep masks and fans across all areas and staff training addressing night-time conduct. Quality of sleep was unrelated to whether the patient and their family were in an open bay or private cubicle. Parents felt that experiencing poor sleep was routine and within their expectations of a hospital admission.
What’s your take home message?
Quality of sleep for parents and children on the St Mary’s inpatient paediatric ward is poor and there are several modifiable contributory factors which can be addressed. Further work on co-producing interventions alongside nursing staff and junior doctors is envisioned with post-intervention data to be collected.