Reducing Routine Overnight Vital Sign Monitoring on Stable Pediatric Patients
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Authors
Schneider, Karmyn
Issue Date
2023-08
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Abstract
Problem: Pediatric patients are enduring unnecessary sleep disturbances because of routine overnight vital sign monitoring. This population of patients are consistently getting less sleep than they need and are accustomed to getting at home, and sleep deprivation in children has been linked to multiple adverse health effects and unfavorable patient experience ratings. Purpose: The primary purpose of this evidence-based, quality improvement project is to increase the utilization of the “Q4 While Awake” vital sign order to reduce the frequency of vital sign monitoring interruptions overnight to facilitate longer spans of time for undisturbed sleep. Methods: The intervention will begin with educating both providers and bedside staff through an interactive learning module. The education will highlight the evidence that supports the project, the inclusion criteria and how to integrate this into the established workflow of the unit. The ordering providers should then begin using the “Q4 While Awake” order for vital sign frequency in stable patients. Visual placards will be placed on ordering providers' computers and at the nursing stations to remind everyone to advocate for a change in vital sign order when appropriate. Results: There were 238 patients that met criteria for the “Q4 While Awake” order in the preliminary data with only 1 having the order (0.42%). After implementation, 164 patients met criteria for the “Q4 While Awake” order and 37 (22.5%) had the order. 90% of assigned staff completed the learning module and there was no evidence of an increased risk of an adverse event or signs of care escalations in patients meeting inclusion criteria. Conclusion: It is safe to reduce routine monitoring in stable pediatric patients to allow for better sleep hygiene in the inpatient setting.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University