27 Prescribing Patterns of Pharmacologic Sleep Agents Following the Implementation of a Sleep Protocol in Adult Burn Patients

Abstract Introduction Sleep disturbances in burn patients can prolong recovery, cause psychological and physiological stress, and put patients at risk for additional complications. A gap exists in the literature regarding optimal pharmacologic sleep agents in burn patients. In September 2014, a sleep protocol was introduced in our burn center to promote sleep-wake cycles through use of non-pharmacologic interventions and pharmacologic agents. Our study objective was to assess sleep protocol implementation and its effects on prescribing patterns of pharmacologic sleep agents in adult burn patients. Methods This retrospective review evaluated outcomes of a sleep protocol in adult patients admitted for burn or inhalational injury between 10/1/16 and 8/31/17. Exclusion criteria were active psychological disorders, pregnancy, or incarceration. The primary outcome was the prescribing pattern of pharmacologic sleep agents (e.g., medication class, name, dose). Secondary outcomes included non-pharmacologic interventions and assessment/documentation of sleep. Results Of 242 patients admitted during the study period, 76 (31%) received first- or second-line sleep agents for pharmacologic intervention as defined by the protocol. Of those, 40 met inclusion criteria. Patient demographics are listed in Table 1. Of the included patients who received pharmacologic treatment, 34 (85%) received first-line medications according to the protocol (p