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Quietnight Superchill Gel Pillow Insert Mat | Cooling Gel Pad | Helps Improve Quality of Sleep | Ideal for Flu Fevers Night Sweats | 40 cm x 30 cm

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Murphy G, Bernardo A, Dalton J. Quiet at night: Implementing a Nightingale principle. Am J Nurs. 2013;113(12):43-51. Patel J, Baldwin J, Bunting P, Laha S. The effect of a multicomponent multidisciplinary bundle of interventions on sleep and delirium in medical and surgical intensive care patients. Anaesthesia. 2014;69(6):540-9. Wilson C, Whiteman K, Stephens K, Swanson-Biearman B, LaBarba J. Improving the patient’s experience with a multimodal quiet-at-night initiative. J Nurs Care Qual. 2017;32(2):134-40. Barnes CM, Drake CL. Prioritizing sleep health: Public health policy recommendations. Perspect Psychol Sci. 2015;10(6):733-7. The team’s completion plan included monitoring and maintaining individual action items, such as monthly meetings to report on current status and to compare current project metrics against preintervention HCAHPS scores. Insights

Quiet or quite ? - Grammar - Cambridge Dictionary Quiet or quite ? - Grammar - Cambridge Dictionary

Lighten our darkness, Lord, we pray; and in your mercy defend us from all perils and dangers of this night; for the love of your only Son, our Saviour, Jesus Christ. Conclusion translation: "The Traitor Dong Zhuo Secretly Harbours a Deposition Plan", from Romance of the Three Kingdoms At the University of North Carolina Medical Center (UNCMC), a Magnet ®-recognized 803-bed level I trauma center, we receive impressive Hospital Consumer Assessment of Health- care Providers and Systems (HCAHPS) scores. However, patients’ responses to the question “During your hospital stay, how often was the area around your room quiet at night?” often fell short. Although specific sources of noise weren’t identified, two facts are certain: Noise levels in acute-care settings have increased significantly over the years, and sleep disturbance among hospitalized patients can impair healing and contribute to functional and psychological impairments. Based on these data, national attention on the role of sleep in health and well-being, and the fact that sleep quality is amenable to nursing intervention, the UNCMC division of nursing identified sleep promotion and noise reduction as annual goals. Evidence-based review Clark A, Mills M. Can a sleep menu enhance the quality of sleep for the hospitalized patient? Medsurg Nurs. 2017;26(4):253-7.

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The authors work at the University of North Carolina Medical Center in Chapel Hill. Christine Hedges is the director of nursing quality and research. Erica Wolak is a senior clinical quality management engineer in nursing quality and research. Cheryl A. Smith-Miller is a nurse-scientist in nursing quality and research. Turkeisha Brown is nurse manager, adult medicine acute care unit. Selected references The project team established process measures to assess adherence to the interventions. Outcome measures included monthly HCAHPS Top Box scores on the quietness of hospital environment and the sources of noise survey scores. The team set a goal of 5% improvement in HCAHPS and a 20% decrease in bothersome sources of noise.

A Quiet Night At Home Lyrics - Genius Bare: The Musical – A Quiet Night At Home Lyrics - Genius

Antiphon: Preserve us, O Lord,* while waking, and guard us while sleeping, that awake we may watch with Christ, and asleep we may rest in peace. Tainter CR, Levine AR, Quraishi SA, et al. Noise levels in surgical ICUs are consistently above recommended standards. Crit Care Med. 2016;44(1):147-52. To trial the identified interventions, the team used Lean QI methods, based on plan-do-study-act (PDSA), to focus on increasing value for the customer (patients), decreasing waste in the process, and developing team members by teaching them how to apply Lean methods. Our project used A3 thinking, a method that provides a framework for conceptualizing a problem, potential solutions, and outcomes. (See A3 thinking.) Antiphon: Preserve us, O Lord, while waking, and guard us while sleeping, that awake we may watch with Christ, and asleep we may rest in peace. PRAYERS CollectGod destined us to obtain salvation through our Lord Jesus Christ, so that whether we wake or sleep we might live with him. The results of the HCAHPS scores, sources of noise survey, and the sleep menu responses suggest that perceived quality of sleep, perception of noise, and overall satisfaction with care can be improved in our setting using simple solutions. However, clinical nurses play an essential role in encouraging a culture of quiet by modeling quiet behaviors. HCAHPS Top Box scores improved on both units; one unit exceeded the 5% improvement goal at 90 days. Both units achieved a reduction in top sources of bothersome noise goals when resurveyed at 90 days, and they continue to work on improvement and sustainment. Nurses’ contribution Based on the interventions identified in the literature evidence tables, the team chose four—offering a sleep menu, offering warm water (shower or bath) at bedtime, replacing noisy equipment, and lowering staff voices—for PDSA cycles of improvement over several weeks. Sleep menu A warm bath or shower before bedtime was impractical to implement on a broad scale in a hospital setting. However, EVS team members suggested a creative approach: Offer warm washcloths to the patients in the evening, which became part of the next experiment and PDSA cycle. Noise level

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