A Nonpharmacologic Sleep Protocol for Hospitalized Older Patients

摘要: OBJECTIVES: To evaluate the feasibility of and adherence to a nonpharmacologic sleep protocol targeted nurses for acutely ill older patients test effectiveness on enhancing reducing sedative-hypnotic drug (SHD) use. DESIGN: Prospective cohort study. SETTING: A 34-bed general medical unit in university-affiliated teaching hospital. PARTICIPANTS: total 175 consecutive admissions aged 70 years or older. INTERVENTION: consisting back rub, warm drink, relaxation tapes was administered by nursing personnel who complained difficulty initiating requested SHD. After 1 hour, if patient still it, nurse SHD. MEASUREMENTS: The main outcomes quality SHD use were measured interview chart abstraction. Feasibility tracked daily interviews abstraction. RESULTS: 111 patients, mean age 79.3 (± 6.4), 68% women, received protocol. Patients required 4.9 days per patient, totalling 539 patients-days. overall rate 400/539 (74%) patient-days. complete nonadherence 139/539 (26%), with reasons including 30 (6%), refusal 104 (19%), contraindications five (1%). correlated strongly number parts received, suggesting dose-response relationship, highest correlation receiving two three (ρ = .64, P < 0.001). successful from baseline preintervention 51/94 (54%) 34/111 (31%) (P .002). had stronger association .75, .001) than did SHDs .07, .45). However, chronic users more likely refuse nonusers (64% vs 41%, .03) 4.5 times often (67% 15%, .001). CONCLUSION: provides feasible, effective, nontoxic alternative promote hospitalized patients. Use can substantially decrease SHDs.