At Sinai Health System in Toronto, 15.9% of patients who were not previously on benzodiazepines or other sedative hypnotics (BSH-naïve patients) were prescribed these medications during their hospital stay. Of these, 87% were inappropriately prescribed for insomnia.
A multi-disciplinary team was established consisting of physicians, nurses, pharmacists and administrators, with the goal of reducing the monthly proportion of BSH-naïve inpatients prescribed a new BSH for sleep by 20% in one year. The initiative consisted of physician and nurse education, order set changes to improve appropriate prescribing, and the creation of a sleep-friendly environment. During the implementation period between September 2015 and July 2016, the rate of BSH-naïve patients who were prescribed these medications declined from 15.9% to 8.9%, a 44% decrease.
The Less Sedatives for Your Older Relatives toolkit contains the key ingredients of their approach.