Sleep deprivation has been linked to poor outcomes in hospitalized patients, and the American Academy of Nursing's Choosing Wisely campaign advises nurses to reduce unnecessary nighttime care. Researchers who created an intervention that combines interdisciplinary education and empowerment with "nudges" in electronic health records (EHRs) tested its effectiveness on subjective and objective measures of sleep disruptors.

In this study, one general medicine unit underwent the full sleep intervention, which included nurse education and empowerment, physician education, and changes to the EHR. The default orders in the EHR were changed to reduce nighttime sleep disruptions from vital sign monitoring, venous thromboembolism prophylaxis, and laboratory orders. Nurses were coached to collaborate with physicians to implement sleep-friendly orders and incorporated the intervention into their daily huddles.

The researchers compared the results of this unit with those of another general medicine unit, which they referred to as the "standard unit." The latter incorporated all of the interventions except the nursing intervention. Sleep-friendly orders (such as those that required fewer disruptions) increased significantly in both units. In the intervention unit, nighttime room entries decreased by 44%. No significant changes occurred in the standard unit. Patients in the intervention unit were also less likely to report disruptions for vital sign monitoring or medication administration.

The authors note that creating a sleep-friendly environment likely depends on the unit-based nurses championing this cause. They caution that this single-site study had several limitations, including that it wasn't a randomized controlled trial and its results may not be generalizable.

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