“Quiet at Night”: Reduced overnight vital sign monitoring linked to both safety and improvements in patients’ perception of hospital sleep quality

Abstract

Obtaining middle of the night vital signs is disruptive to sleep and not founded on evidence-based medicine. We sought to investigate the perception of quality of sleep and overall satisfaction during a hospital stay between an intervention group where overnight night vital signs were not obtained and a standard of care group where overnight vital signs were obtained every four hours. We also monitored for adverse events in the intervention and standard group. Low-risk observational stay patients with a planned cardiac procedure were eligible for this study. After consent, patients were randomized to the intervention or standard group. Participants were provided a questionnaire on the day following their overnight stay to assess their perception of quality of sleep and satisfaction with their hospital stay. Charts were reviewed to assess for any adverse outcomes. During the study period, 39 patients were enrolled in the standard group and 41 in the intervention group. All patients were discharged the following day as planned and no adverse events occurred overnight. More patients in the standard group rated good/excellent sleep at home, and more patients in the intervention group rated good/excellent sleep in the hospital. There was a trend toward less disruptive sleep between home and hospital for the intervention group (p = 0.096). There was no difference found in the overall satisfaction of hospital stay response between the intervention and standard groups (p = 0.999). Fewer patients in the intervention group had worse sleep in the hospital as compared to home, significant at p < 0.10. We also found there was no escalation of care despite not obtaining vitals throughout the night in our intervention group. With this proof of concept now safely implemented, it is our intention to implement further studies to broaden our inclusion criteria and population to encourage a restful and healing environment through the entire healthcare stay.