1. Smyth, Carole A. MSN, ANP-GNP, APRN, BC


What nurses can do to help.


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Nurses can do several things to enhance relaxation and promote sleep for patients in the hospital. Some are rooted in common sense; many are based on evidence. Consider doing the following:


* Assess pain and advocate appropriate pain medicine.


* Partially close doors to patients' rooms to reduce outside light and noise.1


* Speak in low voices, especially at the nursing station.


* Stop using the unit's paging system at night.


* Institute a Sh-h-h-h Project2 or a Silent Hospitals Help Healing (SHHH) program.3


* Suggest that the patient engage in some daytime physical activity, if appropriate. (Some experts believe insufficient daytime activity may contribute to insomnia.4)


* Assess room temperature and adjust thermostat (or change the number of blankets) to the patient's preference.


* Play quiet, soothing music5,6; use a white-noise machine to minimize ambient noise.


* Encourage use of relaxation techniques such as deep breathing or meditation.


* Provide massage (such as back massage). Effleurage-a type of massage that uses long, slow strokes-has been found to promote "biological and subjective relaxation."7


* Suggest a warm bath (immersion to the mid-thorax) before bedtime.8


* Encourage patients to avoid caffeine during evening hours; provide decaffeinated beverages at night.


* Time wound care, medication administration, and the taking of vital signs so as to minimize sleep disturbances.9


* Consider all of the above interventions before asking that a sleep-promoting medication be prescribed.



For more, see Noise Control: A Nursing Team's Approach to Sleep Promotion, February 2004.


Carole A. Smyth, MSN, ANP-GNP, APRN, BC




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