Lights Out - It's Quiet Time

Purpose for the program: A designated Quiet Time was implemented on the Maternal Infant Services unit at Sharp Mary Birch Hospital for Women & Newborns to address patients' feedback about their difficulty getting enough rest during their stay, especially in the first 24 hours after delivery. In addition, providing new mothers with uninterrupted time was expected to promote exclusive breastfeeding.

Proposed change: To provide a desginated time period during which visits from hospital staff were limited to medically necessary visits (i.e. for pain medication) and visits requested by patients. In addition, visitors would be alerted about Quiet Time, lights would be dimmed, the noise level in the hallways and at the nursing stations would be kept down.  Participating in Quiet Time would be optional; however, patients would be encouraged to have visitors come before or after Quiet Time so that they could rest.

Implementation, outcomes and evaluation: An interdisciplinary task force planned the implementation of Quiet Time.  Patient and staff surveys were completed, indicating that both groups were in favor of trialing a designated Quiet Time.  Quiet Time was offered for an hour and a half each day for a month-long trial.  At tne end of the trial, patients and staff completed follow up surveys.  85% of patients surveyed rated Quiet Time positively.  77% of staff members surveyed, including all disciplines providing care to patients, recommended that Quiet Time be continued.  After the trial, Quiet Time was shortened to one hour daily to allow ancillary departments more time to complete their work.  Although the original intent was to offer Quiet Time in the afternoon only, a night shift Quiet Time was established, beginning at the end of visiting hours through shift change in the morning.  Lamps were placed by computer stations to provide more light for staff charting.  

The exclusive breastfeeding rate when Quiet Time was implemented in September, 2009 was 66.4% and increased to 70.4% in July, 2010. Prior to implementing Quiet Time, the Press Ganey patient satisfaction question rating "Noise level in and around the room" was at the 55th percentile and increased to the 65th percentile after Quiet Time implementation. 

Implications for nursing practice: Patient satisfaction, recovery from the delivery process, and successful breast feeding are impacted by the mother's ability to get adequate rest.  Through interdisciplinary collaboration, modifying workflow and providing a designated Quiet Time, patient satisfaction improved, and the rate of exclusive breastfeeding increased.

Keywords: Exclusive breastfeeding, quiet time, patient satisfaction.