I am interested in establishing some sort of Sleep Health and Wellness program for our patients on the PICU. I feel there is so much more that we can do to help them sleep better at night, feel more refreshed and less sleepy in the day. Thereby enhancing the quality of their stay in PICU , ( and maybe that of their parents.) WHY MORE SLEEP? – More sleep promotes healing, reduces delerium and pain, enhances mood, improves appitite, memory and concentration, and restores energy. Sleep deprivation increases pain, delium, agitation, alters mood, affects memory and cognitive function, slows healing and growth. It may also increase risk of stroke, heart attack, diabetes and obesity. Not only does it impact the child, but the parents too. I am proposing that we try some simple interventions for night and day. Then perform research project to identify effectiveness of what was implemented. EVENING/NIGHT INTERVENTIONS 1. TV and electronics off at certain time, low stimulus environment. 2. Keep room dark, or low light for interventions. 3. Use of eye shades and ear plugs. 4. White noise, or sound machines. 5. Avoid all caffiene after certain time. 6. Cluster cares, and have “protected time.” 7. Omit one set of vital signs if possible during night. Or change to q4hrly if appropriate. 8. Formulate a ‘bedtime routine’ with parents help, introduce massage, perhaps use of calming essential oils in room. 9. Pay attention to alarm limits & adjust if necessary. Use remote controls to silence alarms. 10. Close the door at every opportunity. 11. Keep voices down! ( Some research shows alarms and health care peopls converstions are the biggest 2 things that disturb patients.) DAYTIME INTERVENTIONS 1. Wake the patient up at reasonable time each morning, around the same time. 2. Open blinds and turn on lights to create a “day time” environment. 3. Get the patient out of bed as much as is possible. Either sit in chair or on sofa. 4. Mobilize out of the room if possible. 5. More distraction therapy and play. Involve parents, child life, pet therapy, music therapy etc. 6. If needed allow a limited nap in day. 7. Protected time during day. Collaborate with Multidisciplinary team. POSSIBLE OUTCOMES – Less perceived pain, reduced delerium, less daytme sleepiness, less irritability, more easily consoled, improved appetite, happier parents and patient. POSSIBLE OBSTACLES – – Will not work for all patients. – If parents and child haven’t slept, the parents want room dark so child can sleep as long as possible during the day. – May create more work initially for nurses and parents. – Will need co-operation and support from parents, nurses, doctors and multidisciplinary team. – People are resistant to change. – Will still be some noise levels. Patients in room next door, doctors rounds, rooms near entry doors opening and closing. – Cost involved – e.g. earplugs, eye shades, remote controls, sound machines.