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Helping patients to rest and sleep in hospital by Nicky Westwood, Patient Relations & Experience Manager

Nicky WestwoodNicky Westwood

Nicky opened her presentation by saying that they are receiving consistent feedback via a variety of methods relating to poor experience of patients struggling to sleep in our hospital. Not all patients were having problems but there was enough feedback to alert us that we needed to do something different.

Anecdotal evidence existed about what may be the cause – ‘nurses chatting to each other’ and nurse’s shoes clip clopping along the corridor’ were popular reasons. We wanted to challenge perceptions and find out exactly what was causing disturbed rest and sleep. Going back to basics and drill down to the root causes then putting practical solutions in place to address them was the initial work plan. Focus elsewhere seemed to relate mainly to the environment of care, and monitoring of noise levels. Our focus was more on behaviours of staff and patients as well as looking at these aspects.

A triangulated audit was conducted across all wards. This consisted of an environment audit, a staff and patient survey. The results were analysed and cross referenced to optimise the information gained.

25,000 individual pieces of data were collated, analysed and reported identifying some key findings - some were expected, others were surprising.

Actions were taken to address the findings via a trust wide approach. Engagement from staff at all levels was crucial and evident at each stage of the project.

Findings fed into, and were aligned to a number of co-existing action plans, some key actions were led by the Patient Experience team.

Guidelines were produced for staff to support helping patients to rest and sleep in hospital; as well as some patient leaflets. One contained tips to help them rest and sleep as well as some guidelines for them to respect the needs of their fellow patients. Another focussed on relaxation exercises.

The eye mask available via the NHS Supply chain was evaluated and found to be ineffective. The team worked with a group of patient representatives to redesign the mask, then were successful in getting the new design manufactured and included in the NHS Supply Chain catalogue for use across England. This is now the only sleep mask available via this method, feedback from patients has been extremely positive.

Substantial education has taken place so that staff at all levels understand the importance of supporting patients to rest and sleep and are aware of what is at their disposal to support patients experiencing difficulty.

Clear evidence exists that the interventions have had a significant positive impact on patient experience with this reflected in the national patient survey results as well as local patient experience feedback.

This improvement has dipped slightly in the last national survey, prompting a renewed focus and re-audit of current patient experience. This will assist us in establishing what is currently impacting on the experience of patients and where we need to focus our attention to drive further improvements.

In her presentation Nicky States: 

"we wanted to get back to basics and find simple solutions to have a positive impact on the patient experience"

"from our results we found 25% of patients had a disturbed previous night due to pain. We found this completely unacceptable and we were completely unaware and very disappointed"

"it was encouraging to hear that patients felt staff were doing all that they could but we were not complacent"

"we asked patients for help to improve their night. One that came up 'Tuck me in before I go to sleep', never underestimate how important this is"

"we created our guidelines. This is a good toolkit for staff if they have a patient who is struggling to sleep at night. This is now embedded in our trust. We need to help patients to rest all of the time."

"we also created 'Tips to help you rest and sleep in hospital', given to patients who are struggling to sleep or those disturbing others"

"other trusts have already adopted our guidelines and audit techniques"

For further information on this initiative please contact Nicky Westwood, Patient Relations and Experience Manager on 0121 371 4724 or via email 

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Events of interest: 

Monitoring & Improving Patient Safety
Thursday 11 December 2014 London

Measuring and Monitoring Quality
Tuesday 20 January 2015 London

Reducing Medication Errors
Tuesday 27 January 2015 London

Advancing IV Therapy
Thursday 29 January 2015 London

Patient Safety, Incident Reporting, Investigation & Learning
Monday 2 February 2015 London

Eliminating Avoidable Pressure Ulcers
Wednesday 4 February 2015 Birmingham

The National Quality Standard for Surgical Site Infection
Thursday 12 February 2015 London

Investigating Incidents and The Duty of Candour
Tuesday 28 April 2015 London

Developing Patient Accessible Electronic Patient Records
Wednesday 29 April 2015 London

Download: Nicky Westwood Presentation

2 December 2014


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