Effectiveness of SIESTA on objective and subjective metrics of nighttime hospital sleep disruptors

Vineet M. Arora*, Nolan Machado, Samantha L. Anderson, Nimit Desai, William Marsack, Stephenie Blossomgame, Ambrosio Tuvilleja, Jacqueline Ramos, Mary Ann Francisco, Cynthia Lafond, Edward K.Y. Leung, Andres Valencia, Shannon K. Martin, David O. Meltzer, Jeanne M. Farnan, Jay Balachandran, Kristen L. Knutson, Babak Mokhlesi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


We created Sleep for Inpatients: Empowering Staff to Act (SIESTA), which combines electronic “nudges” to forgo nocturnal vitals and medications with interprofessional education on improving patient sleep. In one “SIESTA-enhanced unit,” nurses received coaching and integrated SIESTA into daily huddles; a standard unit did not. Six months pre-and post-SIESTA, sleep-friendly orders rose in both units (foregoing vital signs: SIESTA unit, 4% to 34%; standard, 3% to 22%, P < .001 both; sleep-promoting VTE prophylaxis: SIESTA, 15% to 42%; standard, 12% to 28%, P < .001 both). In the SIESTA-SIESTA-enhanced unit, nighttime room entries dropped by 44% (−6.3 disruptions/room, P < .001), and patients were more likely to report no disruptions for nighttime vital signs (70% vs 41%, P = .05) or medications (84% vs 57%, P = .031) than those in the standard unit. The standard unit was not changed. Although sleep-friendly orders were adopted in both units, a unit-based nursing empowerment approach was associated with fewer nighttime room entries and improved patient experience.

Original languageEnglish (US)
Pages (from-to)38-41
Number of pages4
JournalJournal of hospital medicine
Issue number1
StatePublished - Jan 2019

ASJC Scopus subject areas

  • Leadership and Management
  • Internal Medicine
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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