Journal of hospital medicine : an official publication of the Society of Hospital Medicine
-
Hospitalized patients often experience disrupted sleep due to nighttime patient-staff interactions (PSIs). This study evaluates how PSIs impact sleep opportunities in neurology inpatients using electronic health record (EHR) data and introduces surrogate measures of sleep such as longest uninterrupted sleep opportunity (LUSO) and interruptive episodes. ⋯ This study demonstrates the utility of LUSO and interruptive episodes as EHR-based measures to link PSIs to sleep opportunities. While vital signs and medications were the most frequent PSIs, neurological checks and off-unit testing were associated with the largest impact on reducing LUSO. The predominance of single-PSI interruptive episodes underscores that the bundling of PSIs is not occurring. These findings highlight that PSIs impact sleep opportunities in distinct ways, supporting the use of this methodology to evaluate and address EHR-linked disruptions to patient sleep.
-
Radiologic imaging is routinely performed to aid in diagnosis for hospitalized children. Identifying and reducing variability in imaging practices can improve care while reducing harms and costs. ⋯ To reduce imaging overuse in hospitalized children, conditions with frequent imaging, high imaging-related costs, and high hospital-level variation in imaging practices should serve as priorities for future evidence generation, guideline development, and/or improvement initiatives.