Improving Sleep Quality and Duration in the Postpartum Period through Quiet Time; Patient Satisfaction; Practice Guidelines as Topic

Background: Postpartum patients are routinely disturbed at frequent intervals during their hospital admission, so unbroken sleep is rarely possible. This can lead to sleep deprivation which can have significant adverse health implications such as a decline in cognitive function, and impaired healing. Sleep disturbances have been shown to contribute to increased rates of postpartum depression and anxiety. Growing concerns regarding the adverse health effects of disturbed sleep and sleep deprivation in postpartum patients have led to the introduction of scheduled Quiet Time in postpartum units across the country. This initiative has yielded promising results including improved breastfeeding and increased patient satisfaction. Protocols have been developed to outline measures intended to enhance and encourage Quiet Time. Methods: A sleep protocol guideline was created for urban and rural inpatient postpartum units. A pre-implementation survey was sent to nursing staff to assess attitudes regarding various aspects of sleep in the acute postpartum period. Over a six-week period, the protocol was implemented with patients who indicated a desire to participate. A survey was given to patients at the time of their discharge to assess their satisfaction with Quiet Time. A post-implementation survey identical to the pre-survey was again sent to nursing staff with additional questions eliciting feedback regarding quiet time and the feasibility of continued use of the protocol. Results: A total of 47 nurses completed both pre- and post-surveys. Eighty-two percent (n=38) of the nurses from both hospitals strongly agreed that sleep was very important in the hospital during the postpartum period and 51% (n=24) strongly agreed that they were comfortable adjusting their schedule to accommodate quiet time for the patient. All 16 patients who completed discharge surveys agreed that lack of sleep changed their cognitive functioning. Patients in the rural postpartum unit (n=3) strongly agreed or agreed that they appreciated quiet time and that it increased satisfaction with their birthing experience. Conclusions: Although the sample in this project was small, implementation of Quiet Time was found to be an effective method for increasing uninterrupted rest time for patients in the immediate postpartum period. Further studies need to be conducted in various inpatient settings to determine how the structure of nursing care can be modified to universally accommodate quiet time among low-risk patients in postpartum units and examine outcomes regarding patients' sleep quality and satisfaction with their birth experience.