Sleep is an essential part of the healing process. And, Aultman’s Cardiac Care Unit (CCU) understands the importance of sleep. The Aultman CCU is a 56-bed unit which includes the intensive care unit and step-down rooms. A new addition in the CCU is a sleep cart, which offers items to help patients relax and get a good night’s sleep.

A strong association exists between sleep deprivation and delirium in the elderly, postoperative patients and ICU patients – particularly those who are on ventilators. “The CCU was one of the pilot units when Aultman initially sought the Nurses Improving Care for Healthsystem Elders (NICHE) designation for elder care excellence,” said Rhonda Fleischman, CCU clinical education specialist. “Our project was to develop a program to prevent and manage delirium in older patients.”

The CCU team created a “sleep cart” from which patients can choose items to improve their quality of sleep. The cart includes white noise machines, aromatherapy, lotion for back massages, earplugs and eye masks. A variety of music and reading materials are also available. A flier about the sleep cart is included in the CCU welcome packet patients receive upon admission to the unit.

For the delirium project, the CCU also offered items like crossword puzzles and decks of cards to keep patients’ minds active during the day – in addition to sorting activities and yarn crafts to promote dexterity. “The combination of daytime activities and evening relaxation led to a reduction in the prevalence of delirium, a decrease in the number of ‘sitter hours’ spent with patients and a statistically significant decrease in falls,” Rhonda explained.

CCU nurses started a research study to identify whether or not sleep-promoting interventions like the sleep cart items improved sleep quality in patients who are recovering from heart attacks. The team’s research showed two statistically significant findings. “All of the study participants reported that the sleep cart was helpful. Compared to the baseline measurements patients self-reported on sleep quality, they noted improved sleep when we provided sleep-promoting items and addressed their sleep needs,” Rhonda shared. “Also, there was a significant link between noise level and their quality of sleep.”

The creation and use of the CCU sleep cart has been a true team effort, starting with support from Unit Director Sandy Bogner and the assistant managers. “We are working on sleep promotion as one of our 2016 unit projects. We’ve invited CCU geriatric resource nurses and other bedside nurses to be ‘sleep champions’ for our patients,” Rhonda said. “We couldn't focus on sleep promotion without our nurses and support staff. Taking an extra minute to pull the blinds, adjust the room temperature, offer earplugs and provide a warm blanket makes a big difference!”