Sleep Hygiene for Pediatric Patients


Quality Improvement (QI), in healthcare, is the collective effort and unwavering activity by all the individuals and professionals in the care environment to create an enhanced change in care (Mannion and Davies, 2018). This study will present a critical discussion of the leadership approaches that can be used in conducting the quality improvement in the sleep hygiene framework for paediatric patients in hospitals. This study will also make a critical discussion on how the effective leadership approaches in relation to promote the QI of sleep hygiene of the paediatric ward in the hospitals can improve the standard of safety in the care delivery to paediatric patients. In this study, it will be demonstrated that how the active involvement of service users in the QI process of sleep hygiene can fasten the overall success of the QI project. Under NMC codes the confidentiality is maintained throughout this study thereby maintaining the validity and authenticity of this study.


Critical Analysis of Leadership Approach:

NHS (2019) recommend that in terms of maintaining good and effective sleep hygiene for paediatric patients (children) in hospitals health care leaders and managers must use highly relevant leadership approaches that can assist them to guide the entire care team in the right way to meet the common goals of QI project [NHS, 2019]. As mentioned by Jambawo (2018), different types of leadership approaches are applied in the healthcare context such as autocratic democratic, delegative, transactional and transformation leadership approaches.

In this QI project for quality enhancement of sleep hygiene for children in the hospital setting transformation leadership is selected for achieving the QI objectives (Gifford et al., 2017). In this context, transformational leadership would assist the healthcare leaders and managers to set the realistic QI goals and make the necessary transformation in the resources that are needed to improve the sleep hygiene of the paediatric patients. On supporting this viewpoint Seidel et al., (2019) mentioned in their study, that the transformational leadership approach is highly useful in paediatric care, which assists healthcare leaders to consider and determine the needs and preferences of children before setting the QI goals and then train the entire team in the right way to boost the energy, productivity and inspiration of the entire team to meet these needs.

On the other hand, Krepia et al., (2018) stated that the transformational leadership approach can assists project leaders to delegate tasks effectively and systematically among team members thereby guiding the entire team to develop the task prioritisation skill to attempt and complete the priority task first. In terms of meeting the QI objectives of this project in improving the overall sleep hygiene framework for paediatric patients in the hospital setting the transformational leader would use effective task delegation, which will enable the healthcare leaders to make an appropriate distribution of the task among all the members of the care team thereby ensuring that the entire team will work collaboratively and synergistically on all aspects of sleep hygiene for the children. On supporting this view, Musinguzi et al., (2018) mentioned in their research study that transformational leaders in healthcare can follow a systematic and well-structured work process in which the team members can work collaboratively with all the considerable factors of sleep hygiene such as set the bedtime routines for children, note down the screen time for each child at night and observe the behaviour and activities of each child.

My role as a leader in the paediatric ward:

While working in the paediatric ward in a local hospital I performed as a transformational leader, in which I developed the relevant QI goals for improving the overall sleep hygiene framework and train the entire care team in the right way to improve their productivity. During working in the paediatric ward, I used to perform many tasks for this QI project such as observing children regularly to know their sleeping pattern at night, the screen time for which they are exposed to TV, mobiles and other devices, observe whether there is any deterioration of the duration of sleep for children and notice if there is any change in the behaviour and activities of children (Giddens, 2018).

As a transformational leader, I also determine the transformation that is needed in the skill, abilities and knowledge of members of the care team to assist them to work efficiently on the project goals thereby achieving all the QI objectives. As argued by Musinguzi et al., (2018) as a transformational leader involve all the team members in the decision-making for conducting positive transformation of skill and activities, there are high chances of leaders facing team conflict and unhealthy competition among the team members.

Ways in which the project support improvement

The current QI project aims to implement sleep hygiene by reducing screen time among paediatric patients who are children. This would help in patient care improvement as lowering screen time would make the children be least exposed to the high-energy blue light emitted from the TV, mobile and other screens that promote melatonin release which is the key hormone that supports healthy sleeping (Calvo-Sanz and Tapia-Ayuga, 2020).

As argued by Mortazavi et al (2018), melatonin is released from the pineal gland in the dark that indicate the body feel tired and go to sleep. However, the presence of blue light from TV and other screen creates light sources that minimise melatonin production in the lack of dark. It would create hindered sleeping tendencies that would cause increased stress, forgetfulness, low motivation and others in children (Barrau et al., 2017). Thus, the current action of reducing screen time as taken in the project would limit the sleep hindrance and promote better healthcare for patients. The Quality Improvement project also aims to implement sleep hygiene by promoting management of insomnia in children by making them learn and execute relaxing techniques like muscle relaxation, visual imagery and diaphragmatic breathing. These actions taken in the project would improve patient care as it is going to help in accomplishing sleep hygiene among the children by avoiding insomnia, in turn, limiting the adversities to be faced by children due to adverse sleep schedules (Gupta et al., 2019).

Importance of service-user involvement and co-production in care

‘The centrality of the third sector in the co-production of public services is seemingly based on the assumption that it can act as an effective proxy for service users. However, the third sector encompasses a broad range of organisational forms, interests and governance arrangements, which all have implications for the type and nature of relationships between the sector and its constituencies’ (Mazzei et al., 2020). The importance of service-user involvement and co-production in healthcare is that it allows creating an acceptable healthcare environment. This is because service-users involvement such as in this project the children in understanding the importance of sleep hygiene would make them accept the selected care without objection as they feel and recognise through evidence out of involvement in care that it is for their better health condition (Beresford, 2019). Leaders must focus on partnership working with children and their parents to discuss the issues associated with sleep hygiene. Here organisational leaders need to maintain the clear interaction with children to assist them to feel relax to share their issues in having uninterrupted sleep. here care manager must ensure that all the nursing staffs will use the empathetic communication with each child thereby encouraging children to involve in their sleep hygiene process. in this context, children will be trained a advice regarding the activities that they have to perform and do not have to perform before going to bed to have a a healthy sleep. Under NHS (2019), children must be involved in activities in having a continuous sleeping pattern that is strongly associated with their positive behavioural, psychological and physical development (NHS, 2019). Transformation leaders must observe the changes in the screen times, risk of insomnia, the regularity in sleeping pattern and the activities and approaches children to perform after waking up in the morning (Krepia et al., 2018). Based on all these observations leaders would make proper QI strategies that can be implemented in the paediatric ward to improve the overall sleep hygiene for the children. here the organisational leaders and care manger would involve children for having good sleep pattern in different ways such as children are, making sure that after taking diner children are not exposed to any mobile or TV screen, the reduction of the total screen time for children in a day, keep away all the plays or digital devices from children during their bedtime and maintain the dark and peaceful environment of the paediatric room at the bedtime to improve the sleeping pattern of children.

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The transformational leadership approach is used in the QI improvement project for sleep hygiene promotion for inpatients in the paediatric hospital. This is because such leaders work together with the team to inspire and motivate them for making the essential change in the care environment rather than overshadowing them by playing superficial roles only directing them to make the change. In addition, the current project improves patient care and service as it implements reduced screen time and relaxation techniques to reduce insomnia and sleep disturbance in the patient.


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