SHM Converge Scientific Abstract ePoster Gallery-Lytes Out: Exploring the Efficacy of Order Adjustments to Reduce Overnight Disturbances With Electrolyte Repletion

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This study evaluated whether changing an evidence-based electrolyte repletion order set to default to morning administration could reduce overnight interruptions for hospitalized patients. Because electrolyte replacement is often ordered at night, it can disrupt sleep; the updated “electrolyte hub” was designed to avoid this unless a patient had elevated arrhythmia risk.<br /><br />Researchers compared magnesium and potassium repletion orders during three-month, seasonally adjusted periods before and after the new order set launched. “Overnight” was defined as 10 PM to 6 AM. They analyzed both evidence-based order set–guided orders and all electrolyte orders overall, using chi-squared testing.<br /><br />Results showed a significant reduction in overnight electrolyte administration after the intervention. Across all electrolyte orders, overnight administration decreased from 17.01% before to 15.12% after, corresponding to an 11.07% reduction in sleep disturbance (95% CI 9.59%–12.55%). For all electrolyte orders, overnight use fell from 18.82% to 15.42%, with an 18.06% reduction in sleep disturbance (95% CI 16.35%–19.73%). The effect was stronger when clinicians used the evidence-based order set rather than placing manual orders.<br /><br />The authors conclude that adjusting medication timing within an evidence-based order set can meaningfully reduce overnight patient disruptions. They estimate the change prevented 8,917 overnight electrolyte-related interruptions per year. This may improve sleep, lower delirium risk, and increase patient satisfaction.

Asset Subtitle

Theresa A. Papich

Meta Tag

Author List Alan A. Kubey, Dana M. Jordan, Jeffrey Riggio, Joshua Riley, Theresa A. Papich

Category Research

Concept Electrolyte Order Set

Concept Overnight Medication Administration

Concept Electrolyte Repletion

Concept Sleep Disruption

Concept Morning Administration

Distinguished Non-Finalist

Presenter Organization Thomas Jefferson University Hospital

Presenting Author Theresa A. Papich

Track Quality Improvement

Keywords

electrolyte repletion

overnight interruptions

patient sleep

evidence-based order set

morning administration

hospitalized patients

magnesium

potassium

sleep disturbance reduction

delirium risk

Electrolyte Order Set

Overnight Medication Administration

Electrolyte Repletion

Sleep Disruption

Morning Administration