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Table 2 Interventions to improve sleep/wake cycles and patients’ ability to fall asleep and stay asleep

From: Non-pharmacological solutions to sleep and circadian rhythm disruption: voiced bedside experiences of hospice and end-of-life staff caregivers

Domain Theme Total
Interventions involving interdisciplinary teams 648
  Promote emotional and spiritual support (e.g., address family needs, provide comfort and peace, provide reassurance, and help with realistic expectations) 206
  Provide educational interventions to promote sleep 177
  Support individual circadian rhythms (e.g., adjust clinical processes and medications based on individual sleep assessments, determine causes of sleep problems, encourage a daytime routine, and avoid enforcing a traditional sleep/wake cycle) 168
  Promote physical comfort in patients 49
  Reduce negative stimulation and distraction 48
Interventions involving organizational leadership and management 178
  Provide patient-centered care (e.g., provide case managers and patient advocates to each patient in addition to dedicated staff members for particularly sensitive patients) 59
  Apply monitoring and staff feedback systems 43
  Provide disruptive and high-impact innovations that will lead to substantial improvements in multiple patients 38
  Accommodate alternative sleeping arrangements for patients 15
  Grant control over environment and amenities to staff, patients, and family 10
  Create internal policies to reduce disruptive noises 3
  Ensure that healthcare providers are trained to embrace each facility’s common philosophy 3
  Frequently measure, communicate, and document sleep quality and the impact of interventions 7
Interventions involving environmental and technological resources 128
  Optimize daytime environments (e.g., high-quality mattresses, daylight, soothing colors and scents, individualized sounds, and fresh air) 66
  Optimize night-time environments for sleep (e.g., keep rooms quiet and dark, eliminate odors, and provide white noise) 62
Interventions involving national and state policymakers 59
  Provide disruptive and high-impact innovations that will lead to substantial improvements in multiple patients 38
  Streamline national and federal reimbursement and care-related policies 11
  Dedicate more funding and resources to end-of-life and palliative care 10