Abstract
Introduction
Lakeside unit at the University Hospital of Wales is a rehabilitation and complex discharge planning facility for elderly patients. Recognising the importance of good sleep in rehabilitation, our quality improvement project aimed to assess the feasibility and evaluate the impact of introducing decaffeinated coffee and tea as alternatives to the standard caffeinated options routinely provided to patients. Caffeine is a diuretic and stimulant that disrupts sleep and increases urinary frequency, urgency, and volume. Reducing caffeine can reduce falls related to toileting. Addressing nocturia should be considered in the design of comprehensive fall prevention programs for older adults.
METHODOLOGY
We educated staff and patients about the benefits of decaffeinated drinks through informational sessions and ensured a variety of decaffeinated beverages were available to patients after 5 PM. Over two weeks, our study implemented a controlled intervention, with Week 1 as the baseline control phase. During this period, we assessed falls, frequency of nocturnal toilet visits, and sleep quality. In Week 2, we introduced decaffeinated coffee and tea after 5 PM and continued to monitor the same metrics. Most patients chose decaffeinated drinks when offered.
RESULTS
Data from 202 patient nights in the control week and 240 patient nights in the intervention week were reviewed.
- Sleep:
- Control: 78% good(157), 22% bad(45)
- Intervention: 85% good(203), 15% bad(37)
- Falls:
- Control: 1 fall(0.083 per night per patient)
- Intervention: 2 falls(0.133 per night per patient)
- Toileting:
- Control: 0.87 trips per patient per night
- Intervention: 1.27 trips per patient per night
CONCLUSION
Our small feasibility study noted some improvement in sleep quality, with no significant difference in toileting needs and falls per patient per night. The acceptability of decaffeinated drinks was high. Larger and longer studies are needed to further examine the effects of decaffeinated drinks