The Use of Fit Bits to Monitor Sleep Patterns for

Persons with Dementia

Customer Service Leadership Project

Presented by: Megan Van De Hey

Acknowledgements: Preceptor: Morgan Hinkley, DON: Chad Mackenzie, Behavior and Restraint Review/Fall Incident Team, Neighborhood Staff including Nurse Managers, Nurses, and Certified Nursing Assistants, Brewster Village Residents, Division of Quality Assurance,

UW-Eau Claire HCAD Professors, and UWEC Learning and Technology Services,

Activity

• Track the level of activity and number of steps taken.

• Compare the level of activity before and after they wear the

Fit Bit to see if levels of activity have increased or decreased.

• Compare levels of activity to sleep patterns, fall patterns,

appetite changes, weight loss, and more.

Socialization

• The Fit Bit trackers can be used as a way of increasing

socialization between residents by participating in fitness

and health competitions.

6

3.5

4

6

44.4

4

6.4

4.5

33.2

3.5

1

0

4

1 1

0

1

0

1 1

4

0

1 2 3 4 5 6 7 8 9 10 11 12

Fit Bit Identification Number

Amount of Sleep and Number of Falls For Month 1

Average Hours of Sleep/Night Number of Falls

Brewster Village is a 204-bed, County-owned, short term rehab

and long term care nursing home located in Appleton, Wisconsin.

The Division of Quality Assurance (DQA) approved us for the use

of Civil Money Penalty funds in the amount of $5,000.00 to utilize

Fit Bits to monitor Sleep and Wake Patterns in the dementia

population. The grant supported the purchase of 12 Fit Bits for

participants. The final selection of participants was determined by

the Behavior and Restraint Review/Falls Incident Report Team.

Multiple studies have shown that sleep disturbances affect the

overall quality of life for individuals in long-term care facilities and

especially those with a diagnosis of dementia. There is a need for

more research and interventions to improve sleep patterns in

order to improve and reduce falls, medications, weight loss, and

behaviors. The utilization of Fit Bits is a non-invasive way to

monitor sleep patterns of residents without disturbing their daily

routines. It is using modern technology to complete an overall

comprehensive assessment to improve quality of care.

The overall objective of the program is to be able to provide

better care and improve overall quality of life for residents by

adapting to their individual lifestyle patterns.

Goals

• Establish individualized care plans to provide enhanced care.

•Develop individual daily routines.

•Distinguish fall patterns.

•Individualize meal planning.

•Monitor medication adjustments.

•Improve overall psycho-social well-being.

Step 1

• Compile an itemized budget for the $5,000 approved.

• Determine a time frame of 6 months for data collection.

Step 2

• Submit the grant to DQA and receive approval of the grant.

• Approval received on February 15th, 2017.

Step 3

• Review CASPER reports and other related reports to narrow down residents with sleep disturbances and a high number of falls.

Step 4

• Meet with the Behavior and Restraint Review/Fall incident (QAPI) team to select 12 residents to participate in the study.

Step 5

• Receive consent from candidates and/or their representative.

Step 6

• Purchase Fit Bits and IPads to perform the study.

• Assign a Fit Bit to each resident.

Step 7

• Communicate the details of the study to staff.

• Put together an information binder for each neighborhood.

Step 8

• Sync data from the Fit Bits every Monday and Friday.

• Charge Fit Bits every Monday and Friday.

Step 9

• Compile the data into monthly reports.

• Run monthly fall reports.

Step 10

• Review data reports with the falls QAPI team.

• Submit quarterly data reports to DQA.

Recommended Hoursof Sleep (Average) Actual Hours of Sleep

(Average)

7-8 Hours

4.5 Hours

Amount of Sleep Individuals 65+ Actually Receive Compared to the Recommended Amount

5.3

0

5.1 5.3

4.64.4

4.6

7.3

33.4

4.2

2.7

0

1

2

3

4

5

6

7

8

1 2 3 4 5 6 7 8 9 10 11 12

Week 1 - Average Hours of Sleep/Day

Average Hours

4.44

4.5

6.2

4.2

3.73.5

5.9

4.6

1

2

4.5

0

1

2

3

4

5

6

7

1 2 3 4 5 6 7 8 9 10 11 12

Week 2 - Average Hours of Sleep/Day

Average Hours

6.8

3.2

2.5

5.85

4.3

5

4

6.15.9

3.5 3.4

4

0

1

2

3

4

5

6

7

8

1 2 3 4 5 6 7 8 9 10 11 12

Week 3 - Average Hours of Sleep/Day

Average Hours

• Educate and train staff about the program.

• Share data and results at huddles

and QAPI meetings.• Communicate the objectives and

goals.

Communication

• Discuss the success and areas for improvement.

• Review the data regularly at QAPI meetings.

• Receive feedback from all levels of departments on ways to continuously improve the program.

Continuous Feedback

• Compare the data from the Fit Bits to data in the electronic charts.

• Perform audits to ensure Fit Bits are being worn and properly worn.

Audits

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

FacilityAdjustedPercent

StateAverage

NationalAverage

65.2%

47.8%

45%

3.3%3.8% 3.4%

CASPER Report

Falls

Falls w/Maj Injury

7

3.8

5.6 5.5

3.3

6

3.5

6.2

5.2

2.8

2.1

3.4

2

3

0 0 0

1

2

0

1

2

6

0

1 2 3 4 5 6 7 8 9 10 11 12

Fit Bit Identification Number

Amount of Sleep and Number of Falls For Month 2

Average Hours of Sleep/Night Number of Falls

• The first two months of preliminary data shows that the

residents are averaging 4.5 hours a sleep each night. The

recommended amount of sleep for individuals 65 years and

older is 7-8 hours each night.

Brewster Village Rankings

• 17.4 percentage points above the State average for falls.

• 20.2 percentage points above the National average for falls.

• 0.5 percentage points below the State average for falls with

major injuries.

• 0.1 percentage points below the National average for falls

with major injuries.

PDCA

• To ensure continuous improvement throughout he program, the

Plan, Do, Check, Act (PDCA) methodology will be used.

CASPER Reports

• Compare Brewster Village’s overall quality indicator percentiles to

State and National Percentages.

• Compare previous CASPER report percentages to those

percentages after implementation and action of the Fit Bit

Program.

PDCA Cycle

Plan

Do

Check

Act