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Inpatient sleep deprivation is a serious problem at hospitals because of frequent nighttime awakenings by clinicians to measure vital signs or administer medications.

However, researchers at the University of Chicago Medicine conducted a prospective study\u2014called Sleep for Inpatients: Empowering Staff to Act (SIESTA)\u2014combining electronic \u201cnudges\u201d in the EHR to forgo nocturnal vitals and medications, as well as physician education on how to use the sleep-friendly tools in the Epic EHR system.

Results of the one-year study<\/a>, which involved two 18-room general medicine units at the medical center, were published this month in the Journal of Hospital Medicine<\/i>.

\u201cThe present SIESTA intervention demonstrated that physician education coupled with EHR default changes are associated with a significant reduction in orders for overnight vital signs and medication administration in both units,\u201d according to the authors. \u201cThis study presents several implications for hospital initiatives aiming to improve patient sleep.\u201d

Also See<\/b>: Vanderbilt creates device for ICU patients to digitally filter out medical alarms<\/a>

\u201cEfforts to improve patients\u2019 sleep are not new, but they do not often stick because they rely on staff to remember to implement the changes,\u201d said Vineet Arora, MD, lead author and professor of medicine at the University of Chicago.

Part of the problem was that physicians did not know how to change the default vital signs order requiring them to be taken \u201cevery 4 hours\u201d or how to batch-order morning phlebotomy at a time other than 4 a.m. Working with clinical informaticists as part of the study, researchers changed the EHR system\u2019s default orders.

\u201cOur study is consistent with other research highlighting the hypothesis that altering the default settings of EHR systems can influence physician behavior in a sustainable manner,\u201d according to the authors. \u201cHowever, our study also finds that, even when sleep-friendly orders are present, creating a sleep-friendly environment likely depends on the unit-based nurses championing the cause.\u201d

\u201cThis illustrates the importance of engaging both nurses and physicians to create sleep-friendly environments in hospitals,\u201d added Arora.
","saveContent":"A tweak to default orders in the University of Chicago Medical Center\u2019s electronic health records system is letting patients sleep more soundly at night.

Inpatient sleep deprivation is a serious problem at hospitals because of frequent nighttime awakenings by clinicians to measure vital signs or administer medications.

However, researchers at the University of Chicago Medicine conducted a prospective study\u2014called Sleep for Inpatients: Empowering Staff to Act (SIESTA)\u2014combining electronic \u201cnudges\u201d in the EHR to forgo nocturnal vitals and medications, as well as physician education on how to use the sleep-friendly tools in the Epic EHR system.

Results of the one-year study<\/a>, which involved two 18-room general medicine units at the medical center, were published this month in the Journal of Hospital Medicine<\/i>.

\u201cThe present SIESTA intervention demonstrated that physician education coupled with EHR default changes are associated with a significant reduction in orders for overnight vital signs and medication administration in both units,\u201d according to the authors. \u201cThis study presents several implications for hospital initiatives aiming to improve patient sleep.\u201d

Also See<\/b>: Vanderbilt creates device for ICU patients to digitally filter out medical alarms<\/a>

\u201cEfforts to improve patients\u2019 sleep are not new, but they do not often stick because they rely on staff to remember to implement the changes,\u201d said Vineet Arora, MD, lead author and professor of medicine at the University of Chicago.

Part of the problem was that physicians did not know how to change the default vital signs order requiring them to be taken \u201cevery 4 hours\u201d or how to batch-order morning phlebotomy at a time other than 4 a.m. Working with clinical informaticists as part of the study, researchers changed the EHR system\u2019s default orders.

\u201cOur study is consistent with other research highlighting the hypothesis that altering the default settings of EHR systems can influence physician behavior in a sustainable manner,\u201d according to the authors. \u201cHowever, our study also finds that, even when sleep-friendly orders are present, creating a sleep-friendly environment likely depends on the unit-based nurses championing the cause.\u201d

\u201cThis illustrates the importance of engaging both nurses and physicians to create sleep-friendly environments in hospitals,\u201d added Arora.
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Change in EHR default orders helps reduce inpatient sleep interruptions

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