Date of Graduation

Fall 12-17-2021

Document Access

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project

First Advisor

Alexander Wong



The microsystem suffers from characteristics of common sleep disturbances usually present in long term care environments including high levels of noise and bright lights. This is important to address since sleep disturbances can lead to a plethora of health risks and can contribute to an overall negative patient and staff experience.


The microsystem is a 120 bed skilled nursing facility in San Francisco serving a population of military veterans. Assessment of the microsystem shows that a lack of consistency exists when it comes to identifying interventions to promote the Quiet Hours timeframe. Doors are kept open and lights are not dimmed during the nighttime hours. This project focuses on the standardization of Quiet Hours guidelines using a detailed flier, as well as educating the staff and conducting post education competencies to ensure the intervention was properly received by all staff members.


A set of guidelines was created, including interventions to promote quiet hours, and posted in the hallways followed by conducting staff education sessions during evening and night shift reports. The education content consisted of an introduction to the project, observations made on the unit, the literature used, and a review of the posted guidelines. Each education was followed by a competency handout requiring staff to identify themselves and answer a set of questions to demonstrate understanding and compliance with the intervention.


The outcome measures goal was to reach 100% of staff competency on both the evening and night shifts combined in order to achieve maximum compliance of the intervention.


A total of 81% of staff was educated and accounted for, consisting of 4 out of 7 RNs, 7 out of 9 LVNs, and 19 out of 21 CNAs working the evening and night shifts. This is an improvement from the previous 64% of staff who responded to partially completing the intervention guidelines.


This project brought more awareness to the importance of maintaining a quiet environment during nighttime hours and made it easier for the hospital staff to follow and implement a standardized set of interventions for promoting quality of sleep. Future projects can further explore ways to reduce noise levels and general disturbances during Quiet Hours by creating a Champion role and ensuring that 100% staff competency completion.

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