Allowing the patients to sleep: flexible medication times in an acute hospital.

In 1999, under the leadership and direction of the Director of Clinical Services (Nursing), Roger Napthine, Project Consultant, was commissioned to undertake a review of medication policies and practices for a regional acute-care hospital. This initiative was taken with the view of improving nursing practice and patient care. Recommendations from Napthine's review included the trial in a medical and a surgical unit of a change in the administration of routine morning and evening medication times. A descriptive study that included a convenience sample of 52 patients and 25 registered nurses was conducted in the two units. The findings demonstrated that patients were able to sleep longer. Further, although they tended to wake earlier, their 'in hospital' and 'at home' sleeping patterns were more closely aligned. There was agreement among the nurse participants that the change to flexible medication times allowed patients to sleep longer. However, concerns were raised about the impact of the change on other nursing duties, particularly those performed in the mornings.