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G263(P) ‘No Speaking, Children Sleeping’ a Quality Improvement Approach to Improving Children’s Sleep on a Hospital Ward
  1. RS Bevan,
  2. L Halloran,
  3. A Adamolekun,
  4. C Mattina,
  5. V Dublon
  1. Paediatrics, Royal Free Hospital, London, UK


Introduction It is recognised that children and their resident carers sleep poorly in hospital wards. Qualitative research in a children’s hospital found that parents identify noise at night other patients or parents, noise from hospital equipment, and noise from staff as significant causes of poor sleep. Parents have reported that staff talk too loud overnight, affecting sleep.

We believe parents on our children’s ward have a similar experience, and the group overseeing this work have noticed noise at night-time. We are therefore hoping to improve patient experience through improving sleep at night by decreasing unnecessary noise.

Methods We are making changes to decrease noise at night, primarily by educating staff on the importance of keeping the ward quiet overnight. We have started displaying posters with the slogan ‘no speaking, children sleeping’ requesting staff to be quiet after 8 pm. This has recently been changed to 9 pm to accommodate the timing of nursing bedside handover. We will be making further efforts to educate staff about noise at night, including creating a ward display board, and to inform parents about our work.

We have conducted a short survey of parents to ask their feedback on sleep and noise. We intend to repeat the survey at intervals to evaluate the effect of our changes, taking a plan-do-studyact approach.

Results Of 8 parents, 3 reported their child had poor or very poor sleep the night before completion of the survey. 4 felt there was unnecessary noise, and parents reported beeping machines, doors, and staff talking as contributing factors to the noise levels. Results from repeat surveys will be presented.

The Friends and Family Survey results also guide our work. Our ward has over 95% positive feedback in the Friends and Family Survey, but noise at night is one of the main negatives. Discussion Noise at night is an important contributor to sleep quantity and quality of children and their resident carers on the paediatric ward. Effecting changes in noise is difficult as some of the noise is clinically necessary, and because of staff’s reluctance to change their behaviour. We hypothesise that we will overcome this with further staff education on sleep.

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