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Sleep promotion in the intensive care unit—A survey of nurses’ interventions

Originally Published:
2011
Key Point Summary
Key Point Summary Author(s):
Eliassen, K. M.
Hopstock, L. A.
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Key Concepts/Context

For patients in the intensive care unit (ICU), sleep deprivation could lead to a variety of physical and psychological issues (Friese, 2008) that impact the healing process and increase morbidity and mortality. There are many factors that contribute to poor sleep. This small-scale study investigates the perceptions of the sleep-promoting interventions that ICU nurses provide. The authors’ literature review found four main approaches: noise reduction, light reduction, patient-comfort improvement, and clustering of patient care activities to allow uninterrupted time for sleep. The researchers conducted an email survey.

Reviewer note: This study uncovers some interesting discussion about how the negative effects of light and noise in an ICU environment is mitigated by nurses. It is a great opportunity for designers to explore more sleep-promoting options.

Objectives

This survey research study explored the perceptions of sleep-promoting interventions that ICU nurses provide to lessen the effects of noise, lighting, and frequent patient care activities on patients’ sleep.

 

Methods

Researchers created an e-mail-administered, web-based questionnaire to collect information on the nurses’ interventions to promote night- and daytime patient sleep in accordance with the literature findings. A total of 25 ICU nurses working in an adult ICU with medical and surgical patients at the University Hospital of Northern Norway completed the survey.

Design Implications
Nurses can improve the ICU environment to encourage sleep by coordinating care activities, preparing the patient for sleep, and minimizing disturbing stimuli.
Findings

According to the survey results, ICU nurses reported an overall interest and awareness in sleep-promoting interventions using all four approaches. However, nurses may prioritize the interventions depending on the challenges they are facing in caring for critically ill patients with demands of frequent assessment and nursing.

The main results of the survey reveal an overall interest and awareness in sleep-promoting interventions. However, there are some discrepancies between the strategies suggested in the literature and the interventions performed by the nurses.

Limitations

The authors note that self-reported data may produce a bias, and some respondents may have answered how they were expected to. Other research indicates nurses who prioritize sleep also initiate more sleep-promoting interventions, the actual correlation between what is reported and what is actually performed is unknown. The researchers developed the questionnaire, and it was not subject to formal validation tests. The small sample size, lack of randomization, and the fact that the study was conducted in only one ICU means generalization is limited. Nurses who did not read their hospital e-mails during the data collection period due to vacation or sick leave were not excluded, and this may have negatively influenced the response rate.

 

Design Category
Acoustic Environment|Lighting (artificial and natural)
Setting
Hospitals
Outcome Category
Patient / resident health outcomes
Environmental Condition Category
Lighting|Sound
Key Point Summary Author(s):
Eliassen, K. M.
Hopstock, L. A.
Primary Author
Eliassen, K. M.