The Management of Short-Term Insomnia for Inpatients in an Adult Acute Admissions Ward: Audit of Compliance With Local and National Guidelines

Abstract

Aims

This study sought to establish local adherence to the following recommendations for the management of short-term insomnia (under 3 months duration): 1. Sleep hygiene advice should be utilised prior to pharmacological management. 2. A non-benzodiazepine hypnotic medication should be prescribed. 3. A one-off trial dose of benzodiazepine or Z-drug should be prescribed prior to regular prescription.100% of patients reviewed by medical staff for insomnia are expected to meet the set standards.

Methods

Retrospective analysis of a cohort of patients (n=21), in an Adult Acute Admissions Ward in the West of Scotland. Taken over seven days in January 2023. Electronic prescriptions and chronological notes were reviewed in order to identify patients reviewed by medical staff for short-term insomnia.

Results

Of the patients reviewed for insomnia (n=8):

• • 12.5% were offered sleep hygiene advice (n=1).

• • 25% were prescribed a trial dose of non-benzodiazepine hypnotic medication (n=2).

• • 25% % were prescribed regular non-benzodiazepine hypnotic medication with no trial dose (n=3).

• • 50% were prescribed alternative sedative medication for insomnia (n=4).

Conclusion

Commonly, patients were not provided with sleep hygiene advice. The patients who were prescribed non-benzodiazepine hypnotic medication were often not prescribed a trial dose. Half of the patients were prescribed an alternative to a non-benzodiazepine hypnotic medication.

• • Interventions will include:

  Creation of a sleep hygiene information leaflet to provide to inpatients, medical and nursing staff.

• • Presentation of data to medical and nursing staff.

• • Ensuring guidelines are available to all medical and nursing staff in the ward environment.

• • The audit will be repeated in six months after the interventions.