Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-7-2026

Graduate Advisor

Elizabeth Segura, Nursing

Committee

Elizabeth Segura, DNP, APRN, FNP

Wilma Calver, PhD, MPE, RN

Christina Stafford, PharmD, BCPS

Abstract

Abstract

Background: Sleep disturbances affect the quality of sleep hospitalized adults experience, possibly extending patient recovery time. Treatment of insomnia frequently includes pharmacological interventions exposing patients to potential side effects, leading to negative patient outcomes.  The purpose of this project was to determine if a sleep hygiene toolkit including eye masks, earplugs, advocacy cards, and removal of nicotine patches at bedtime would improve patient sleep quality without use of pharmacological interventions.

Methods: A descriptive observational design was used in this quality improvement (QI) project. A convenience sample of 37 (N =37) participants over the age of 18 years and English speaking were provided a sleep hygiene toolkit after their first night of sleep in the hospital. A Richards-Campbell Sleep Quality (RCSQ) questionnaire was completed by participants at that time. A second RCSQ questionnaire was completed by participants at the time of discharge to measure sleep quality after use of the sleep hygiene toolkit. A hospitalist entered orders into participants’ electronic health record for nicotine patch removal at bedtime if appropriate.

Results: Advocacy cards were the most utilized intervention at 97% (n=36). Eye masks were second at 32% (n=12), and nicotine patch removal was third with 16% (n=6) of participants utilizing this intervention. Improvement was noted in every category on the RCSQ questionnaire after implementation of the sleep hygiene toolkit with sleep depth having the largest increase at 47.8% from pre-intervention to post-intervention.

Implication for practice: Implementing a sleep hygiene toolkit as well as ensuring orders for nicotine patch removal at bedtime in the electronic health record when appropriate can improve sleep quality for hospitalized adults and decrease a need for pharmacological sleep interventions.

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