Table 2.

Summary of Naptime Protocol Elements.

Institution level	Hospital-wide quiet time protocol and quiet pack Overhead pages only for life-threatening emergencies Coordination of pharmacy, laboratory medicine, information technology, and facilities services Leadership Support
Unit level	Visitor policies and encouragement of family members to rest at home Provider meetings in closed work spaces No unit level overhead paging Alarm policies and work groups Restriction of main ICU door use Leadership support
Bedside	Closed door and curtains Dimmed lights Signal to sleep Daytime wake protocol
Direct care	Care clustered and disturbance minimized during room entrances Medications scheduled outside of Naptime Continuous infusions use higher volumes or higher concentrations Routine labs or diagnostic testing at 04:00 or later Ventilator checks and suctioning before and after Naptime Skin care, wound care, and line checks before Naptime Positioning disturbance minimized with “pillow pull” Facilities and supplies outside of Naptime
Challenging cases	Minimize collateral disturbance for medical emergencies Cluster care for high-intensity patients to achieve rest blocks of 60 to 120 minutes Cluster and prioritize in-room care for overnight admissions. Encourage patients in challenging rooms to utilize ear plugs or eye masks

Abbreviation: ICU, intensive care unit.