Running head: SLEEP DEPRIVATION AND PATIENT SATISFACTION

Postpartum Sleep Deprivation and its Effect on Patient Satisfaction

Blake Williams

Brigham Young University-Idaho

NURS 420

Brother Butikofer
Sleep Deprivation and Patient Satisfaction 1

Postpartum Sleep Deprivation and its Effect on Patient Satisfaction

Background

Hospitalized patients are routinely deprived of sleep, which is one of the most important

ingredients in the healing process. According to the research of Vencensi, Pearce, Redding,

Brandonisio, Tzou, & Meiusi, 2016, hospitalized patients reported that their sleep in the hospital

setting was interrupted by things such as pain, alarms, wires, tubing, loud conversations,

medication administration, vital sign checks, and lack of bedtime routine. Some of these

interruptions to sleep are necessary, hourly rounds must be made, medications are due in the

middle of the night, another patient may have an emergency down the hall, the possibilities for

sleep interruptions are endless.

Not only is sleep being disturbed in hospitals, but often little thought is taken by nurses to

actively help their patients sleep. Patients in the Vencensi et al. (2016) study suggested that

simple interventions such as providing a warm blanket, bedtime snack, earplugs, eye mask, or

providing a structured bedtime routine would go a long way to improving their sleeping

experience while in the hospital. Patients also suggested that clustering nighttime care such as

vital sign checks and medication administration into one visit from the nurse would allow for

more uninterrupted sleep. The study shows that sleep is being disrupted and little thought and

effort is being put into helping patients sleep. Most nurses are aware that some of their actions

disturb the sleep of their patients and are aware of the importance of sleep in the healing process,

but nothing changes. One of the main problems with letting patients sleep undisturbed is lack of

monitoring and assessment. The last thing a nurse, or a hospital wants is for a sleeping patient to

have an emergency event and experience serious preventable harm, or death. For example a

patient in the postpartum unit is always at risk for postpartum hemorrhage and they must be
Sleep Deprivation and Patient Satisfaction 2

checked regularly for their safety. This valid concern from the nurses and hospital administrators

is on of the main reasons that sleep is interrupted so often.

Significance

Patients need to be constantly monitored for their safety and for liability purposes, but

patients also need sleep in order to heal, and become healthy. Quality sleep has been shown to

have positive effects on nearly every aspect of health. Research by Finan, Goodin, and Smith

(2013) suggest that deprivation of sleep can contribute to the impairment of important

mechanisms that contribute to pain tolerance. Simply by allowing more quality sleep a patient

will be able to experience less pain as they recover. Michalopoulos, Vrakas, Makris, and

Tzathas (2018) preformed research that shows lack of sleep leads to the release of inflammatory

Cytokines. These Cytokines lead to exacerbations of inflammatory diseases such as irritable

bowel syndrome. They also increase intestinal permeability leading to the spread of bacterial

endotoxins, and leads to a decrease in melatonin levels, cutting off beneficial anti-inflammatory

and antioxidant effects. The literature is extensive, sleep is so crucial to healing that it seems

asinine that sleep is so often interrupted in hospitals.

Quality sleep not only plays an important role in physical healing, but it also effects a

patients psychological and emotional well-being. According to Clark and Mills (2017), long

lasting sleep deficits lead to tiredness, irritability, as well as confusion. They also found that

patients whose nurses were specifically trying to accommodate sleep preferences are much more

satisfied with their sleep, as well as the over-all care they receive. Many common nursing actions

lead to patient sleep deprivation, which results in slower healing, increased complications, and

decreased patient satisfaction.

Kolcaba’s Comfort Theory

Sleep Deprivation and Patient Satisfaction 3

The nursing theory that addresses hospital sleep deprivation best is the comfort theory of

nursing by Katherine Kolcaba (1994). According to Kolcaba (1994) a patient’s level of comfort

is closely related to their ability to be and remain healthy. Kolcaba explains that comfort is a

state of relief, ease, and transcendence. Kolcaba defines relief as experiencing a need being met.

Examples of this in a hospital setting could be a patient receiving pain medications, or having a

surgery that alleviates illness. Ease is explained as a content and relaxed state of being. A nurse

could help a patient be at ease by exercising compassion, lending a listening ear, or providing a

therapeutic atmosphere. Transcendence, Kolcaba elaborates, is when a person has their normal

capacities increased, allowing them to rise above the challenges that face them.

The three aspects of comfort are related to, and dependent upon each other. For example,

the nurse of a cancer patient may create a calm and comfortable environment for their patient

attempting to put their patient at ease, but if the patient is experiencing severe pain, they will not

be able to be put at ease until they receive relief from their pain. Once the patient is able to feel

relieved and at ease, they will be enabled to find the mental and emotional fortitude to overcome

their challenge of fighting cancer. In their research, Krinsky, Murillo, and Johnson (2014)

applied Kolcaba’s theory of comfort to cardiac patients. They found that a loud, noisy

environment can have detrimental effects on patient healing. They implemented a period of

quiet and calm in the units they were studying. They found that implementing this quiet period

reduced harmful stimuli, and created an opportunity for therapeutic interaction to take place for

the patients. These interventions provided relief from stressful, obnoxious noise and also

allowed patients to be put at ease through calm interactions with the health care team.

Understanding the principle of comfort allows a nurse to be conscientious of their patients, and
Sleep Deprivation and Patient Satisfaction 4

provides a guide for planning interventions that will facilitate greater patient comfort, leading to

better patient outcomes.

Kolcaba’s Comfort Theory and Sleep Deprivation

Kolcaba’s comfort theory is very applicable to the issue of sleep deprivation in hospitals

because lack of sleep leads to an increase in healing time, irritability, and stress. Acute-care

patients in the research study by Gardner, Collins, Osborne, Henderson, and Eastwood (2009)

reported that having a period of quiet time each day was very beneficial and therapeutic to their

recovery process. Patient perception and attitudes play a role in their ability to overcome

challenges, this relates directly to Kolcaba’s (1994) concepts of relief, ease and transcendence.

A patient is relieved of noise and distractions, is able to be at ease, and then they are enabled to

respond positively to challenges.

Kolcaba’s comfort theory is especially applicable to sleep deprivation in hospital

postpartum units. Parents are struggling to adapt to the changes in their lifestyle. A new infant

will already interrupt the sleep of these patients. Nurses coming in and out of the room to assess

the mother for bleeding, giving medications, and checking vital signs will compound the sleep

issue. All this after many of these new mothers have been up all night in active labor. These

constant interruptions leading to lack of sleep are extremely overwhelming to new parents.

Research by Bhati and Richards (2015) showed a major association between postpartum sleep

deprivation and development of postpartum depression. While they are still in the hospital

patients should be helped to get adequate amounts of quality sleep. Nurses can relieve the stress

of constant sleep interruption, put patient’s at ease, and help them achieve transcendence so that

they feel confident in their ability to care for their newborn competently
Sleep Deprivation and Patient Satisfaction 5

Research Methods

Implementing the use of a sleep menu in postpartum units will increase the level of

patient sleep satisfaction and overall patient satisfaction ratings. Sleep is a fundamental human

need, a lack of sleep in patients will cause their perceptions of care to be generally negative,

conversely improving patient sleep will result a positive perception of their overall care.

Improving the sleep that patients have in the hospital is a simple, inexpensive way for hospitals

as a whole to increase the quality of care that their patients receive and even raise their Hospital

Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores.

Using Kolcaba’s comfort theory (1994) as a guide, implementing this type of research

will focus on meeting the patient’s sleep needs. As patient’s sleep needs are met, they will feel

more comfortable. Restful sleep will provide relief for a population who is going through a

major life altering transition. As patients experience this increased level of comfort, they will be

happier, and feel more capable of facing the challenge of raising their new child.

Research Design

This research study will be a quantitative research study. The book Understanding

Nursing Research explains that quantitative studies produce results that can be quantified, or

represented by a number. Quantitative studies are typically very objective, and they typically

require a large number of participants (Grove, Gray, & Burns 2015). Because of their objectivity

and the large number of participants involved, the findings from quantitative studies are typically

transferable to other groups and populations.

This study will employ the quasi-experimental subsection of quantitative research.

Quasi-experimental research, according to Grove et al. (2015), is used to learn the effect that one
Sleep Deprivation and Patient Satisfaction 6

variable has on another variable. Quasi-experimental studies do not have the same level of

control that true experimental studies have, but are still capable of producing conclusive results.

Quantitative, quasi-experimental research will be used in this research study because it

allows researchers to determine the relationship between use of a sleep menu and overall patient

satisfaction, without expending the time and resources that true experimental research studies

require. For example, it would take a great deal of resources in order to ensure that each patient

in this experiment was receiving the exact same level care and concern from their nurses in

response to their sleep menu requests. Using the Quasi-experimental approach, this study will be

able to reach a larger group of participants. Another reason for this approach is that it uses a

realistic setting for the research study. Because of this, researchers can be confident that the

findings of this study are transferable to everyday practice in the hospital setting.

Research Population

Participants for this study will include post-partum patients at three hospitals in south

eastern Idaho during the first two quarters of 2019. Only patients who have been in the hospital

three days or fewer, and whose babies are “rooming in” with the parents will be eligible to be

included as participants. Patients with serious sleep disorders will be excluded, as well patients

who have life threatening conditions who require extensive monitoring, such as serious

hemorrhaging and diabetes. Between the three hospitals involved an estimated 1,000-1,500

patients will participate in this study.

The three hospitals chosen exist within a close geographic region which will improve the

ability of researchers to interact with the nurses and nurse managers involved in this research.

Patients whose babies are spending nights in a nursery or NICU will not be included as

participants because without their newborns in the room to interrupt their sleep these patients
Sleep Deprivation and Patient Satisfaction 7

would have a very different sleep experience than the other participants in the study. Postpartum

patients typically do not stay in the hospital for long periods of time, patients will only be

included in the study for a maximum of three morning sleep surveys.

Some potential participants will be excluded from this study in order to keep outliers

from disrupting the research results. Patients with serious sleep disorders would have poor sleep

scores regardless of nurse interventions. Patients with life threatening conditions, such as serious

hemorrhage, require frequent assessments during the night, and many patients with diabetes need

to be awoken multiple times throughout the night for blood glucose checks. These factors make

these patients much different than the other research participants and including them would

impact data heavily.

Methods and Measurements

In order to recruit help for this study the institutional review boards (IRB) of all three

hospitals will be contacted, and the research will be proposed to them as an inexpensive way to

improve patient care and help raise their HCAHPS scores. Once approval is secured from the

IRBs the next step is to contact the nurse managers for the women’s centers at each of the

hospitals. Nurse managers will be the researchers primary link to the nurses who will be

essential to the success of this study. The nurses will receive training on how to use the sleep

menu and sleep surveys from researchers and nurse managers. Because the success of this study

lies in whether or not the nurses embrace the idea of improving patient sleep, incentives will be

provided. The two nurses from each hospital whose patients report the highest sleep satisfaction

grades will receive a 20-dollar gift card. The reward system will be based only on the sleep

grade not the overall satisfaction rating. This will motivate the nurses to change the way they

help their patients sleep but not necessarily change anything else in how they provide care for
Sleep Deprivation and Patient Satisfaction 8

their patients. This will help establish a stronger connection between the level of sleep

satisfaction and overall satisfaction.

This study will consist of two periods, each lasting three months. During the first period

nurses will give their patients a survey each morning with their breakfast tray. The survey will

ask the following questions: How many times was your sleep interrupted last night? What were

the causes of the interruptions to your sleep? On a scale from one to five how satisfied are you

with last night’s sleep? How satisfied are you with the overall care you are receiving in the

hospital? The last two questions will both use the scale: 1-extremely dissatisfied, 2- dissatisfied,

3- neutral, 4-satisfied, 5- very satisfied. After the first three-month period, a sleep menu will be

initiated for the two smaller hospitals. The larger hospital will serve as a control group, they will

not use the sleep menus but will continue to use the morning surveys. The sleep menu will be

similar to the method used in research by Clark and Mills (2017) and will consist of simple

actions and considerations such as providing supplies for a night time routine, bedtime snacks,

earplugs, warm blankets, and eye masks. All nurses will be encouraged to keep patients’ doors

shut, dim hallway lights, and cluster night time care such as vital sign checks, and medication

administration if possible when the mother is already up feeding the infant.

Measurements from this survey will mostly be for two purposes. The first two questions

will primarily be for practical use and application by the nurses and nurse managers. Nurses will

be able to see how many times their patient’s sleep is interrupted and what is waking them. This

will help nurses to adjust their care to allow for better sleep quality. Those questions will also

qualify the sleep satisfaction grade that the patients assign. If the patient gives a low sleep

satisfaction grade but only reported being awoken by nursing actions once during the night then

researchers and nurses know that they are doing their part to facilitate patient rest. The data from
Sleep Deprivation and Patient Satisfaction 9

the two satisfaction scores will be examined for correlational relationship, this will determine if

using a sleep menu improves overall patient satisfaction. The control group that did not use the

sleep menus will provide information to researchers and nurse managers on whether the sleep

menu improved sleep scores or if simply having a survey and incentives for nurses is sufficient

to improve patient sleep quality and satisfaction.

Ethical Considerations

This study presents the risk of making participants victims of covert data collection.

Covert data collection encroaches on a participant’s right to self-determination (Grove et al.,

2015). Nurses need to explain to their patients that the sleep menu and surveys that they are

filling out are part of a research study and patients are not required to participate. The main

problem with this is lack of control. The nurses in this study become de-facto data collectors and

must be well trained by researchers and nurse managers to ensure patient rights are being upheld.

Another ethical consideration in this study is the risk for falsification of research. Grove

et al. (2015) explain that falsification of research includes changing, manipulating, or leaving out

data from a study. It also includes manipulating the resources or procedure of the study. A nurse

who forgets to give their patient their sleep survey may fill the form out for them to save time. A

nurse motivated by the incentive of a gift card may omit a patient’s bad score. Researchers may

also change data if it is not following the trend that they hypothesized it would. These scenarios

can be avoided keeping data private until the study is completed, providing the sleep menu to the

patient with their breakfast tray each morning, and ensuring that data is collected, recorded, and

measured using proper techniques.

The nurses in this study are not technically the research participants but they heavily

involved and are at risk for coercion. Nurses may feel pressured to take on the added
Sleep Deprivation and Patient Satisfaction 10

responsibility to participate in this study when they are already very busy. Nurses will be

encouraged to participate, but will be assured that participation is not mandatory. The incentives

that are being offered are small enough so that coercion should not result from the possibility of

losing a reward.

Annotated Bibliography

Dolan, R., Huh, J., Tiwari, N., Sproat, T., Camilleri-Brennan, J. (2016). A prospective analysis

of sleep deprivation and disturbance in surgical patients. Annals of Medicine and Surgery,

6. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735557/

The authors of this study are colorectal surgeons working at two Scottish hospitals.

Researchers in this study used a quantitative, quasi-experimental approach in their work.

A strength of this research is that researchers looked at preoperative sleep patterns and

postoperative sleep patterns to gain more clarity into how the hospital setting and surgery

affect a patient’s sleep patterns. A weakness of this study is that the population was

relatively small and the nature of the patient’s surgeries caused the median age of

participants to be 69 years old. With the vast majority of the participants being elderly

this study lacked diversity. This article is moderate quality research because of the lack

of control that researchers had in their patient’s environment. Patients in this study were

located in bays containing five other patients. The other aspects of this study were well

designed, but lack of control leads to lack of conclusiveness in results. This study is

intended to address healthcare workers. It is particularly important for nurses because it

provides information about nursing actions that awaken their patients throughout the

night, as well as other factors that nurses can take measures to prevent. These research

findings are applicable to postpartum sleep deprivation because a postpartum patient

Sleep Deprivation and Patient Satisfaction 11

deals with the same kinds of interruptions as a post-surgical patient such as pain, nursing

assessments, and environmental factors. Nurses in all fields can take the findings from

this study and apply it to their practice.

Kowalewska, B., Kaminska, A., Rolka, H.J., Ortman, E.B., Krajewska-Kulak, E. (2014).

Progress in Health Sciences, 4. Retrieved from

http://web.a.ebscohost.com.byui.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=0&sid=57

99e5cc-f927-4f1a-a8cb-f74a6f01efa6%40sdc-v-sessmgr02

The authors of this study are employed in the medical institutes of two Polish

universities. This was a qualitative-phenomenological study. This study involved 100

women of different backgrounds. Approximately equal numbers of women identified

themselves as blue-collar workers as identified as white-collar workers. This diversity

strengthens the conclusions of this study. The main weakness of this study is that 66% of

participants were not informed of their rights as participants. The quality of this study is

moderate to poor because it is somewhat difficult to see exactly how to apply what is read

into actual practice. For example, the phrase “conditions in the unit” is used many times

without fully explaining what is meant by the phrase. The intended audience of this

study is healthcare workers or hospital leaders, because it does offer suggestions on how

to improve patient satisfaction. This study is valuable to nurses because it identifies

factors that lead to dissatisfied patients such as lack of tidiness or lack of a peaceful

atmosphere. The main connection that this study has to postpartum sleep deprivation is

the finding that the third highest ranking cause of dissatisfaction in new mothers was that

the delivery room atmosphere was not pleasant and peaceful. Postpartum nurses can
Sleep Deprivation and Patient Satisfaction 12

expect that their patients will have similar feelings regarding the desired atmosphere in

their rooms.

Meltzer L., Davis, K., Mindell, J. (2012). Patient and parent sleep in a children’s hospital.

Pediatric Nursing, 38. Retrieved from https://search-proquest-

com.byui.idm.oclc.org/docview/1010056351/59494194A8FA4182PQ/3?accountid=9817

The writers of this article are collogues at the Children’s Hospital of Philadelphia.

Aspects of both qualitative and quantitative research were used, and the research would

be classified as descriptive. A strength of this study is the large number of participants

for this type of survey, there were 75 items on the survey and 130 patients and parents

participated. A weakness of the study was that the extensive nature of the survey most

likely deterred more participation. The thoroughness of this research indicates its high

quality. Demographic information was taken as well as the participants typical sleep

patterns and what factors may have interrupted sleep the previous night. The intended

audience of this study is nurses and nurse leaders. This research is useful to give nurses

perspective on what they can do to improve their patients sleep as well as insight into

what the parents or visitors of patients may be experiencing. This is very applicable to

the postpartum setting because in many cases the newborn’s father or grandmother is

rooming in with his family. Often times little thought is taken to how the “non-patient” is

doing.

Parfitt, Y., Ayers, S. (2014). Transition to parenthood and mental health in first-time parents.

Infant Mental Health Journal, 35. Retrieved from

http://web.b.ebscohost.com.byui.idm.oclc.org/ehost/pdfviewer/pdfviewer?vid=0&sid=00

0fbb7c-4071-421e-b5e7-e4776113db87%40sessionmgr103
Sleep Deprivation and Patient Satisfaction 13

The researchers in this study are professors of psychology at two British universities.

They use qualitative-phenomenological research to explore factors effecting the mental

health of first-time parents. The involvement of both mothers and fathers is a strength of

this research because often times this type of research focuses exclusively on the mother.

A weakness of this study is that data collected related to the pregnancies of women was

retroactive, which subjected the data to bias. This research seems to be moderate quality

because the participants were recruited from another research study, which suggests that

some convenience sampling took place. The targeted audience of this research is other

researchers, because this research mainly implies that more research needs to be done in

order to determine the direction of relationship between the variables involved in this

study. This research is important for nurses because it can raise awareness of what

factors influence a new parent’s mental health status. This is applicable to the subject of

postpartum unit sleep deprivation because the study found that sleep had a major impact

on the mental well-being of both the mother and the father. Sleep also impacted the

quality of their relationship with each other, which was also shown to play a large role in

the mental well-being of new parents.

Implications

Nursing Knowledge

This study will improve nurse’s knowledge about their patient’s sleep patterns. It will

also give insights into the effect that quality of sleep has on a patient’s overall perception of care.

Because patients will be able to state how many times throughout the night they are awakened

and what caused them to wake up, nurses will be able to better understand which of their actions

impede their patient from being able to get the rest that they need. The patient’s will also be able
Sleep Deprivation and Patient Satisfaction 14

to request items and actions that facilitate their sleep through the use of the sleep menu. Nurses

will then be able to take that knowledge and adjust their care to optimize time for sleep. If this

study shows that as a patient receives more quality sleep their overall satisfactions increases,

hospital management will be able to make fairly simple changes that will improve patient

satisfaction and Hospital Consumer Assessment of Healthcare Providers and Systems

(HCAHPS) scores.

Nursing Theory

The framework of this study is linked back to the comfort theory of nursing by Kathrine

Kolcaba (1994). This research has the potential to show that quality sleep in hospitals is an

integral aspect of comfort. It can show that it is necessary for a patient to have quality sleep in

order to have the mental and physical strength to heal and cope with the challenges that they

face. This all leads to better patient outcomes and higher levels of patient satisfaction. If the

results of this study are as hypothesized, they will further validate and reinforce the principles

that are laid out in the comfort theory of nursing (Kolcaba, 1994). It will show that quality sleep

is relieving to patients, puts them at ease, and allows them to transcend the challenge of having a

newborn baby.

Nursing Practice

This study has major implications for nursing practice. Postpartum nurses will be more

aware of actions that commonly interrupt their patients sleep. They will be able to adjust their

care to allow their patients to have better sleep. If patients who use the sleep schedule have

better quality of sleep then those who do not postpartum units may begin to implement a sleep

schedule into their ordinary care. If the research shows that quality of sleep has an effect on

patient satisfaction in postpartum units other areas of hospitals may want to implement similar
Sleep Deprivation and Patient Satisfaction 15

actions to improve patient satisfaction and healing. Similar studies can be performed in medical-

surgical units, or intensive care units to discover common nursing actions that interrupt sleep as

well as simple actions to promote quality sleep.

Improve Patient Care

By simply asking a patient how many times they were woken up during the night, a nurse

can become aware of how their patient is sleeping which is a crucial part of the healing process.

By asking patient’s what it was that woke them from sleep nurses gain the information that they

need to create a better environment that allows for therapeutic sleep. Nurses may consider

keeping lights in the hallways off and doors closed. Nurses will make a better effort to cluster

care so that they do not need to interrupt their patient’s sleep. Patient care can be improved just

through the knowledge gained by asking how many times patients were woken, and what it was

that woke them. Both of these questions are included in the sleep survey in this study.

Implementing a sleep menu allows a patient to customize the care that they receive to

improve their sleep. Patient’s know their sleep patterns better than any nurse does so using a

sleep menu give power to the patients to affect the care that they receive. Patients who sleep best

after a snack can have a snack. Patients who tend to be cold at night can ask for an extra

blanket. Patients who struggle to sleep without some nighttime hygiene can be provided with a

washcloth, a toothbrush, etc. Patients who require a nap during the day my request period of “do

not disturb unless necessary” during the day. Using a sleep menu allows a patient to have more

say in their care.

The reason that the patient sleep score and patient satisfaction scores are included in this

study is to provide hospital administration with an incentive to implement actions that improve

patient sleep. Hospitals are, at their core, businesses if there isn’t a monetary reason for change,
Sleep Deprivation and Patient Satisfaction 16

change may not happen. Improved patient satisfaction means that patients in a hospital will give

better HCAHPS scores. Better HCAHPS scores lead to more money and patients for the

hospital. This study has the potential to show hospital administrators that it makes financial

sense to make systemic changes that are considerate of patient sleep.

Recommendations

This study, or aspects of it, should be repeated in other hospital units such as medical

surgical unites and intensive care units. Sleep deprivation is just as important for a patient

recovering from illness or surgery as it is for postpartum patients. The research showing that

quality sleep aids in the healing process has been well documented, but this study has the

potential to also show that sleep quality has a major impact on overall patient satisfaction. This

would mean that it is financially important for hospitals to improve the sleep of their patients.

Further research needs to be done to find the best ways to improve patient sleep. The

research in this study is deliberately multi-faceted in order to explore various factors that affect

patient sleep. One goal of this study is to prompt further, more focused research to discover even

more. For example, a whole study could be dedicated to discover what items should be included

on a sleep menu. Another study could be devoted to nurse’s attitudes about their patient’s sleep

and what would best motivate nurses to take their patient’s sleep more seriously. Another study

could be conducted on the effect of having sleep periods during the day as well as at night.

Allowing longer periods of uninterrupted sleep puts patients at risk for complications that

go unnoticed. Frequent contact with patients helps keep patients safe which is a top priority, but

this frequent contact can interrupt a patient’s sleep. If patients are to be left alone to sleep for

longer than normal amounts of time, they should be attached to automatic monitors that will give

their nurses an idea of how they are doing even if the nurse is not going into their room. For
Sleep Deprivation and Patient Satisfaction 17

example, in postpartum units the greatest risk is for hemorrhage. If a patient is connected to a

monitor that gives continuous heart rate, oxygen saturation, and regular blood pressures, their

nurses can be made aware if their patient’s vitals begin to trend in the wrong direction. Nurses

can then enter their patient’s room to assess their patient. As technology continues to improve

this will become more and more effective. Nurses will always be challenged to find the balance

between allowing patient sleep and preserving patient safety. Use of monitoring technology can

help achieve a healthy balance between sleep and safety.

Sleep Deprivation and Patient Satisfaction 18

References

Bhati, S., Richards, K. (2015). A systematic review of the relationship between postpartum sleep

disturbance and postpartum depression. Journal of Obstetric, Gynecologic, and Neonatal

Nursing, 44. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/1552-

6909.12562

Clark, A., Mills, M., (2017). Can a sleep menu enhance the quality of sleep for the

hospitalized patient? MEDSURG nursing, 26(4), 253-257. Retrieved from

https://byui.idm.oclc.org/login?url=https://search-ebscohost-com.byui.idm.oclc.org/

login.aspx?direct=tru&db=cin20&AN=124650212&site=eds-live

Finan, P.H., Goodin, B.R., Smith, M.T. (2013). The association of sleep and pain: an update

and a path forward. National Center for Biotechnology Information, 12. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/24290442

Gardner, G., Colins, C., Osborne, S., Henderson, A., Eastwood, M. (2009). Creating a

therapeutic environment: A non-randomized controlled trial of a quiet time intervention

for patients in acute care. International Journal of Nursing Studies, 4. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/19167711

Grove, S., Gray, J., Burns., N. (2015). Understanding nursing research, 6th Edition.

[VitalSource]. Retrieved from https://online.vitalsource.com/#/books/9781455770601/

Kolcaba, K.Y. (1994). A theory of comfort for nursing. Journal of Advanced Nursing, 19,

1178-1184. Retrieved from http://www.thecomfortline.com/files/pdfs/1994%20-

%20Holistic%20Comfort%20for%20Nursing.pdf
Sleep Deprivation and Patient Satisfaction 19

Krinsky, R., Murillo, I., Johnson, J. (2014). A practical application of Katharine Kolcaba’s

comfort theory to cardiac patients. Applied Nursing Research, 27. Retrieved from

http://daneshyari.com/article/preview/2644859.pdf

Michalopoulos, G., Vrakas, S., Makris, K., Tzathas, C. (2018). Association of sleep quality and

mucosal healing in patients with inflammatory bowel disease in clinical remission.

Annals of Gastroenterology, 31(2), 211-216. Retrieved from

http://www.annalsgastro.gr.byui.idm.oclc.org/index.php/annalsgastro/article/view/3532/4

327

Vincensi, B., Pearce, K., Redding, J., Brandonisio, S., Tzou, S., & Meiusi, E. (2016). Sleep in the

hospitalized patient: nurse and patient perceptions. MEDSURG Nursing, 25(5), 351-

356. Retrieved from

https://byui.idm.oclc.org/login?url=https://search.ebscohost.com/loginaspx?direct=true&

db=alpha&AN=118640443&site=eds-live