Now that I’ve returned to clinical medicine, this article from US News and World Report seemed appropriately well timed.  When physicians round in the morning, we often ask our patients how their night went and if they slept okay.  Most of the time, they tell us that they had a hard time sleeping – often they wake up due to noise in the hospital or because health care workers are entering their rooms to draw blood or take vitals.  We usually joke that “no one comes to the hospital to get a good night’s rest”, “this is a hospital, not a hotel” or “you come to the hospital to get better, but no one lets you sleep!”

Several measures have been introduced to try to make this better, including patient satisfaction metrics including the level of noise patients experience while in the hospital.  Increasingly, hospitals are paying attention to the noise levels within their halls.  But it seems that waking patients up in the middle of the night to check vitals signs may not only be of minimal value, but may in fact do more harm than intended.

A study recently published in JAMA Internal Medicine reports that nearly half of hospitalized patients who are regularly wakened to have vital signs checked fall into extremely low risk categories.  Letting low risk patients sleep may actually be better for their health, and doing so would free up nursing time to be spent on sicker patients or double-checking medications and orders to prevent medical errors.

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