Date of Award

Spring 5-31-2026

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Tracie Gadler, DNP, APRN, ACHPN, RNFA, FNP-C

Abstract

Abstract

Nearly two thirds of skilled nursing facility (SNF) residents report poor sleep. Negative consequences of poor sleep are depressed mood, anxiety, pain, cognitive impairment, increased risk for dementia, fatigue, decreased concentration, and lower activity participation. A review of literature has shown that implementation of non-pharmacological sleep interventions can significantly improve sleep quality. The aim to screen SNF residents on current self-reported sleep quality and provide non-pharmacological sleep interventions. The evidence-based project utilized the 8 A’s Model. Using the Pittsburg Sleep Quality Index (PSQI), a resident with a score above 0, received the non-pharmacological sleep hygiene bundle: eye mask, earplugs, and education on the importance of sleep quality using a standard of care educational pamphlet. For those enrolled, self-reported sleep quality was reassessed two weeks, four weeks, and six weeks later for comparison. On the PSQI total scores range from 0 to 21, with a global score of less than five indicating good sleep quality, and greater than five indicating poor sleep quality. On average, at week zero resident global score was 9.05, and at week six it dropped to 2.33. Results concluded that self-reported sleep quality was improved from poor to good over a 6-week intervention as indicated by global scores on the PSQI. Non-pharmacological sleep hygiene interventions can improve sleep quality in adult residents in a SNF. The project demonstrated implementing a sleep hygiene bundle addresses poor sleep quality in a low-cost manner leading to improved outcomes.

Keywords: Skilled nursing facility, Pittsburgh Sleep Quality Index, non-pharmacological interventions, sleep hygiene, sleep quality

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