Creating a therapeutic environment : a non-randomised controlled trial of a quiet time intervention for patients in acute care

Gardner, Glenn E., Collins, Christine, Osborne, Sonya, Henderson, Amanda, & Eastwood, Misha (2009) Creating a therapeutic environment : a non-randomised controlled trial of a quiet time intervention for patients in acute care. International Journal of Nursing Studies, 46(6), pp. 778-786.

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Background: Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. Objectives: The study aim was to evaluate as cheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients’ rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients’, visitors’ and health professionals’ satisfaction, and organisational functioning. Design: The study was a multi-centred non-randomised parallel group trial. Settings: The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. Participants: All patientsadmitted to the two wards in the5-month period of the study were invited to participate, withafinalsample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. Methods: Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and well being were collected using previously validated instruments: a Castle Model 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. Results: Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a ‘perceived’ difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of patients awake in the control group. Overall, patients, visitors and health professionals were satisfied with the quiet time intervention. Conclusions: The findings show that a quiet time intervention on an acute care hospital ward can affect noise level and patient sleep/wake patterns during the intervention period. The overall strongly positive response from surveys suggests that scheduled quiet time would be a positively perceived intervention with therapeutic benefit.

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30 citations in Web of Science®
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ID Code: 26002
Item Type: Journal Article
Refereed: Yes
Keywords: Acute Care Nursing, Non-Randomised Controlled Trial, Nursing Intervention, Quiet Time
DOI: 10.1016/j.ijnurstu.2008.12.009
ISSN: 0020-7489
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Clinical Nursing - Secondary (Acute Care) (111003)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2009 Elsevier Ltd.
Copyright Statement: NOTICE: this is the author’s version of a work that was accepted for publication in International Journal of Nursing Studies. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal of Nursing Studies, 46 (6) 2009 DOI 10.1016/j.ijnurstu.2008.12.009
Deposited On: 29 Jun 2009 01:31
Last Modified: 29 Feb 2012 16:34

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