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Co‐Design of a Sleep Improvement Intervention for Persons Living With Dementia Boarding in the Emergency Department
Adrian D. Haimovich, Natalie Jansen, Sarah Nessen, Sumin Yoon, Sydney Mulqueen, Kylee Maclean, Hannah Kerman, Sarah D. Berry et al.. Academic Emergency Medicine, 2026-03-01
Topic: Risk, prevention and care in population studies
Twenty-six participants (15 ED clinicians, 3 caregivers, 8 community advisors) contributed perspectives. Three overarching domains emerged: (1) current practices-participants described the ED as a noisy, brightly lit, and disruptive environment that undermines sleep; (2) potential solutions-stakeholders suggested structured nighttime routines, clustering of care tasks, noise and light reduction strategies, delirium carts offering non-pharmacologic interventions, and greater caregiver involvement; and (3) barriers and facilitators-participants emphasized staffing constraints, lack of dementia-specific training, and the need for local "champions" to sustain interventions. Community advisors stressed tailoring approaches to individual patient needs and involving caregivers in decision-making. Through participatory co-design, we identified multilevel strategies to improve sleep for PLWD boarding in the ED. Interventions that reduce environmental stimulation, integrate familiar routines, and enhance staff dementia training may mitigate sleep disruption and delirium risk. Future work will evaluate implementation feasibility and downstream effects on patient outcomes across diverse ED settings.
Key findings
- Twenty-six participants (15 ED clinicians, 3 caregivers, 8 community advisors) contributed perspectives.
- Three overarching domains emerged: (1) current practices-participants described the ED as a noisy, brightly lit, and disruptive environment that undermines sleep; (2) potential solutions-stakeholders suggested structured nighttime routines, clustering of care tasks, noise and light reduction strategies, delirium carts offering non-pharmacologic interventions, and greater caregiver involvement; and (3) barriers and facilitators-participants emphasized staffing constraints, lack of dementia-specific training, and the need for local "champions" to sustain interventions.
- Community advisors stressed tailoring approaches to individual patient needs and involving caregivers in decision-making.
- Through participatory co-design, we identified multilevel strategies to improve sleep for PLWD boarding in the ED.
- Interventions that reduce environmental stimulation, integrate familiar routines, and enhance staff dementia training may mitigate sleep disruption and delirium risk.
Why it matters
This co-design study gathered perspectives from clinicians, caregivers and community advisors on improving sleep for people with dementia boarding in the emergency department. Stakeholders suggested strategies such as reducing noise and light and involving caregivers, which may mitigate sleep disruption and delirium risk, but implementation feasibility and effects on patient outcomes have not yet been evaluated.
Study details
- Evidence strengthLow
How this study scored 36/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 35 of the 96 points we could judge it on, which is 36 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Academic Emergency Medicine) |
| Journal's citation record | 2 / 4 | Academic Emergency Medicine: journal h-index 177 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 4 / 6 | Cited 8.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Anita Chary holds only 5 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 2 / 3 | Baylor College of Medicine: institution h-index 1,607 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41877312) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 35 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 35 of the 96 points we could judge it on is 36 out of 100. |
| Total | 36 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Haimovich, A. D., Jansen, N., Nessen, S., Yoon, S., Mulqueen, S., Maclean, K., et al. (2026). Co‐Design of a Sleep Improvement Intervention for Persons Living With Dementia Boarding in the Emergency Department. Academic Emergency Medicine. https://doi.org/10.1111/acem.70274
Vancouver
Haimovich AD, Jansen N, Nessen S, Yoon S, Mulqueen S, Maclean K, et al. Co‐Design of a Sleep Improvement Intervention for Persons Living With Dementia Boarding in the Emergency Department. Academic Emergency Medicine. 2026. doi:10.1111/acem.70274. PMID: 41877312.
BibTeX
@article{haimovich2026-41877312,
author = {Haimovich, Adrian D. and Jansen, Natalie and Nessen, Sarah and Yoon, Sumin and Mulqueen, Sydney and Maclean, Kylee and Kerman, Hannah and Berry, Sarah D. and others},
title = {{Co‐Design of a Sleep Improvement Intervention for Persons Living With Dementia Boarding in the Emergency Department}},
journal = {Academic Emergency Medicine},
year = {2026},
doi = {10.1111/acem.70274},
pmid = {41877312},
url = {https://doi.org/10.1111/acem.70274}
}
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