Shhh! It's Quiet Time From 2 to 4: Our Family Is Bonding Beyond This Door

   ^{_{Purpose for the program:}}

Creating a quiet environment on a Mother/Baby unit can be challenging. Literature suggests that implementing “Quiet Time” (QT) can increase patient satisfaction and promote healing. The purpose of this project was to initiate a QT program that would provide families and their new infants an uninterrupted time period to rest, bond, and breastfeed.

  ^{_{Proposed change:}}

Hospital Consumers Assessment of Health Providers and Systems (HCAHPS)  scores related to quiet environment and feedback from discharged mothers confirmed the need to reduce interruptions. QT was conceived after the Mother/Baby Shared Decision Making Council reviewed the literature and current practice and identified potential solutions. QT is a daily two-hour period in which no one may enter the patient’s room unless requested by the patient.

   ^{_{Implementation, outcomes and evaluation:}}    

The Iowa Model for Evidence-Based Practice and Kaizen quality improvement techniques guided the project.  The typical number and timing of interruptions per day were observed to determine when the least amount of traffic was entering/leaving patient rooms.  2-4 PM was identified as the best time for QT. Implementation involved collaboration and coordination with several departments, and education about the benefits of QT and its impact on daily routines. Changes in work routines for several services were required to avoid interrupting patients during QT.  The QT concept was presented at MD Department meetings.   Letters were sent to MDs to describe the program and purpose of the change. Maternal Child staff was educated and a date was set for implementation. QT signage was created and displayed.  Flyers were given out during maternity tours, childbirth classes and to patients on admission.   QT was also advertised on the facility’s website and in monthly publications.  During implementation, meetings continued to discuss/resolve issues and promote full adoption. Since starting QT, positive feedback was obtained from discharge phone calls and no complaints about interruptions have been received. HCAHPS scores for “patients room always kept quiet” increased from 70% in 4^th quarter 2011 to 78% in 2^nd quarter 2012.  Although it is not possible to conclude that QT increased exclusive breastfeeding, it may contribute to the increase in rates from 33% in January 2012 to 63% in July 2012.

^{_{Implications for nursing practice:}}

New mothers need time to rest, heal, and bond with their infants.  Providing QT each day can contribute to improved patient satisfaction and increased exclusive breastfeeding rates.

^_Keywords:

quiet time, breastfeeding, patient satisfaction