Purpose for the Program
Creating a quiet environment in the mother–baby unit can be challenging. Literature suggests that implementing quiet time (QT) can increase patient satisfaction and promote healing.
To initiate a QT program that would provide families and their new infants an uninterrupted period to rest, bond, and breastfeed. The scores related to a quiet environment from the Hospital Consumers Assessment of Health Providers and Systems (HCAHPS) and feedback from mothers who were discharged 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 2-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 and leaving patient rooms. It was identified that the best time for QT was between 2 p.m. and 4 p.m. Implementation involved collaboration and coordination with several departments, and education about the benefits of QT and its effect on daily routines. Changes in work routines for several services were required to avoid interrupting patients during QT. Letters were sent to physicians to describe the program and purpose of the change. The 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 and childbirth classes, and were also distributed to patients on admission. QT was also advertised on the facility's web site and in monthly publications. During implementation, meetings continued to discuss and resolve issues and promote full adoption. Since starting QT, positive feedback was obtained from follow-up phone calls with patients who were discharged and no complaints about interruptions have been received. HCAHPS scores for “patients room always kept quiet” increased from 70% in the fourth quarter in 2011 to 78% in the second quarter in 2012. Though 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 rates of exclusive breastfeeding.