Excessive noise can stimulate the cardiovascular system and increase gastric acid secretions, leading to discomfort, according to the Center for Health Design. Disrupted sleep can affect a patients ability to heal and increase morbidity by decreasing oxygen saturation, delaying wound healing, and increasing heart and respiration rates.
Because of this evidence, Aleyamma Eapen, RN, MSN, ADN, senior associate director of nursing of inpatient med/surg services, implemented the quiet time project on B4 West at Queens Hospital Center in Jamaica, N.Y. The 15-bed surgical unit was selected for the project because of its size and population focus. The primary initiative for the project was to improve patient care, comfort and satisfaction. Methods used to maximize efforts and compliance focused on education of staff, patients and families about the significance of quiet time and its process.
Quiet time is a collaborative effort that helps reduce stress and noise on the unit, particularly sounds coming from the busy nursing station. Quiet time takes place daily from 12:30 to 1:30 p.m. To increase awareness, stands are posted at the entrance and exit of the unit along with a sign on each patients door.Rosa Narvaez, RN
Lights in the corridors are dimmed, and all patients doors are closed except in rooms with patients who are at high risk for falls and need close observation. Activities prohibited during this time include routine tests, housekeeping services, therapies, announcements and paging. However, essential tests, therapies, emergency housekeeping services, emergency announcements and pages are permitted at this time. For maximum effectiveness, all patient needs must be met before the start of quiet time to ensure patients are comfortable.
In one year, statistical analysis of results revealed that after the implementation of quiet time, patient and employee satisfaction increased from 60% to 80% positively affecting work performance and safety. The data, collected from 2008-09, was published in the hospitals 2010 Hospital Consumer Assessment of Healthcare Providers and Systems Inpatient Patient Satisfaction Survey Results.
Not only is this project beneficial to patients and staff, it also is a cost-effective method of providing a healing environment.
Overall feedback was positive in the report with patients saying that having one hour to rest or meditate was rewarding because they felt more relaxed when they were able to get some uninterrupted sleep. Nursing and ancillary staff also reported feeling more at ease when given the time to unwind and regroup.
The 11 permanent morning personnel involved in the implementation of quiet time gave the project a 100% satisfaction rate and compliance obtained. The project was such a success, head nurse Susan Stenbar-Clarke, RN, is pushing to have quiet time extended to the night shift.