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For OTD capstone, Bolin studies effects of improved sleep on healing

By Luanne Williams

McKenzie Bolin has never spent a sleepless night in the hospital. But she knows how bad she feels when she doesn’t get her rest.

“If I don’t get eight hours of sleep a night, I’m not a good human being to be around,” says Bolin, who picked up her doctor of occupational therapy (OTD) degree on Wednesday morning during Wingate’s graduate Commencement. For her capstone project – the grand finale of Wingate’s doctoral program – she’s spent the past 14 weeks at Duke University Medical Center figuring out how to ensure that patients get a shot at some shut-eye.

“OT is about the activities of daily living, and sleep is a recognized occupation,” Bolin says. “It’s something every human being needs, and it can be addressed by OTs throughout the lifespan. When you are a patient in the hospital, your number one goal is to heal. Sleep is the foundation for all the interventions OTs can do to help with the healing process.”

Bolin’s passion to help improve patient sleep started with a research paper she co-authored with Dr. Melissa Sweetman, director of Wingate’s OTD program, that was published in January in the Open Journal of Occupational Therapy. According to the research they reviewed, 8 out of 10 patients experience sleep deprivation during their hospital stay and nearly 9 of out 10 practitioners believe sleep deprivation in the intensive care unit negatively affects the recovery process.

To tackle the problem, Bolin identified some of the most common factors that negatively influence sleep: the environment, psychosocial elements and patient care. And she proposed evidence-based interventions to address them. 

Between January and April she led a team of OTs at Duke, explaining the importance of sleep to patients, demonstrating the use of eye masks and ear plugs and showing them how to use music channels on the hospital TVs to play relaxation music. She also talked with patients about the importance of staying awake during the day and establishing a routine to make it easier to sleep at night. The team also followed up to find out whether the interventions were effective.

“We found that implementing a sleep-hygiene program was beneficial for patients, and staff agreed it was feasible to add to their standard practice,” Bolin says. “Patients reported increased satisfaction with their sleep, and staff reported it was a useful program that they hope to expand on and add to their regular evaluation process of all patients.”

She said her program also garnered attention from the nursing and medical staff, who will be working closely with OTs to continue addressing patients’ sleep. As a result of her work, OT staff at Duke will be trained to incorporate sleep hygiene into their patient-education efforts, and nursing staff will be educated on how to “bundle” care (accomplish multiple tasks in a single visit), promote daytime wakefulness and reduce pain at night. She left behind a 17-page report on her project to offer guidance.

But the patients and OTs at Duke were not the only benefactors of Bolin’s capstone. Bolin learned a lot about herself and gained confidence as she heads out into the workforce.

“This capstone experience allowed me to take a project I had mentally developed over a year ago and actually put it into practice,” Bolin says. “I learned how to develop a program, overcame obstacles along the way, and led a research project by myself for the first time. This process taught me how to take an overwhelming, large project and tackle it head-on. I learned a lot about how to put sleep-hygiene intervention research and theories into practice, as well as how to guide and coach my colleagues to do the same.”

In addition to her doctorate, Bolin also earned the OTD program’s inaugural Scholarship Award.

“This award is reserved for the graduate who exemplifies the role of a scholar through a commitment to the production of scholarly works that contribute to the profession of occupational therapy’s body of knowledge,” says Sweetman.

Now that she’s earned her degree, Bolin is headed to work at Atrium’s CMC-Main.

“I hope to take what I learned from my capstone to improve patients' sleep there,” she says.

The Jacksonville, Fla., native was one of 32 students in Wingate’s first OTD graduating class. Wingate’s is one of just two doctoral occupational therapy programs in North Carolina.

Learn more about studying occupational therapy at Wingate

May 21, 2021