深度睡眠与哔哔声 II：普外科患者睡眠质量改善项目。

Deep sleep and beeps II: Sleep quality improvement project in general surgery patients.

机构信息

Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

出版信息

Surgery. 2022 Dec;172(6):1697-1703. doi: 10.1016/j.surg.2022.09.013. Epub 2022 Oct 28.

DOI:10.1016/j.surg.2022.09.013

PMID:38375787

Abstract

BACKGROUND

Poor sleep leads to poor health outcomes. Phase I of our sleep quality improvement project showed severe sleep disturbance in the ward setting. We implemented a novel PostOp Pack to improve sleep quality.

METHODS

Patients underwent elective, general surgery procedures. Fitbit trackers measured total sleep time. Patients completed the inpatient Richards-Campbell Sleep Questionnaire, which combines 5 domains into a cumulative score (0-100). Patients completed the outpatient Pittsburgh Sleep Quality Index preoperatively and postoperatively. Patients received the PostOp Pack, which included physical items and a sleep-protective order set to reduce nighttime awakenings. Patients from phase I served as the historical control. The primary outcome was the percentage of patients with Richards-Campbell Sleep Questionnaire total sleep score ≥50. The secondary outcomes included the mean Richards-Campbell Sleep Questionnaire domain scores and Fitbit total sleep time.

RESULTS

A total of 49 patients were compared with 64 historical controls. The percentage of patients with a total sleep score ≥50 was significantly higher in patients receiving a PostOp Pack versus historical control (69% vs. 44%, difference 26%, 95% confidence interval 6.1-45%, P = .01). The mean Richards-Campbell Sleep Questionnaire Total Sleep Score was significantly higher in patients with a PostOp Pack (62 vs 49, mean difference 13, 95% confidence interval 6-21, P ≤ .01). The PostOp Pack Richards-Campbell Sleep Questionnaire domain scores were significantly higher in various areas: Sleep Latency (68 vs 49, P ≤ .01), Awakenings (56 vs 40, P = .01), Sleep Quality (61 vs 49, P = .02), and Noise Disturbance (70 vs 59, P = .04). Of all patients, 92% would use PostOp Pack again in a future hospitalization. No patients had a failure to rescue event with PostOp Pack. The mean total sleep time was significantly improved with PostOp Pack on night 1 (6.4 vs 4.7 hours, P = .03).

CONCLUSION

The PostOp Pack improves inpatient sleep quality and is safe.

摘要

背景

睡眠质量差会导致健康状况不佳。我们睡眠质量改善项目的第一阶段显示出病房环境中严重的睡眠障碍。我们实施了一种新的术后包来改善睡眠质量。

方法

患者接受择期普外科手术。Fitbit 追踪器测量总睡眠时间。患者完成住院 Richards-Campbell 睡眠问卷，该问卷将 5 个领域合并为一个累积分数（0-100）。患者在术前和术后完成门诊匹兹堡睡眠质量指数。患者接受术后包，其中包括物理项目和睡眠保护医嘱集，以减少夜间觉醒。第一阶段的患者作为历史对照。主要结果是 Richards-Campbell 睡眠问卷总分≥50 的患者比例。次要结果包括 Richards-Campbell 睡眠问卷各领域得分的平均值和 Fitbit 总睡眠时间。

结果

共比较了 49 例患者和 64 例历史对照。接受术后包的患者总睡眠时间得分≥50 的比例明显高于历史对照组（69%比 44%，差异 26%，95%置信区间 6.1-45%，P=0.01）。接受术后包的患者 Richards-Campbell 睡眠问卷总睡眠评分明显更高（62 比 49，平均差异 13，95%置信区间 6-21，P≤0.01）。术后包 Richards-Campbell 睡眠问卷各领域得分在各个方面均较高：睡眠潜伏期（68 比 49，P≤0.01）、觉醒次数（56 比 40，P=0.01）、睡眠质量（61 比 49，P=0.02）和噪音干扰（70 比 59，P=0.04）。所有患者中有 92%在未来住院时会再次使用术后包。使用术后包后没有患者发生抢救失败。术后包第 1 晚总睡眠时间明显改善（6.4 比 4.7 小时，P=0.03）。