Weidi Wang, Xinyan Cao, Jiabin Luan, Qi Zhang, Chun Cai, Juan Han
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引用次数: 0
Abstract
Background: Patients in the intensive care unit (ICU) suffer from significant sleep disturbances, which can negatively impact their healing and overall health. Nurses, as the primary caregivers, need to have expertise in sleep management to ensure better patient outcomes. Implementing nurse-led, evidence-based sleep protocols in ICUs is crucial.
Aim: This study aimed to improve ICU patients' sleep quality by developing and implementing a nurse-led, evidence-based SLEEP Bundle, including Sleep initiative, Light control, Eye mask and earplugs usage, Environment noise cancellation and Provision of non-pharmacological (aromatherapy and music therapy) and pharmacological (dexmedetomidine and painkillers) support.
Methods: The Framework of Evidence-based Continuous Quality Improvement and the Ottawa Model of Research Use framework were used to guide the development, implementation and assessment of the SLEEP Bundle. A quasi-experimental study was conducted in a 12-bed surgical intensive care unit (SICU), assessing patient-perceived sleep quality, nurses' self-report knowledge, attitudes and actions regarding patient sleep conditions and nurses' adherence to the interventions.
Interventions: In order to successfully translate evidence into clinical practice, the protocol was crafted with significant nurse involvement, input in sleep promotion materials and a flexible continuing education component, which provided credits to encourage nurse participation. A sleep-aid kit, complete with non-pharmacological tools, and a system of regular quality control and feedback were integral to the clinical application of the protocol.
Results: The intervention significantly enhanced ICU patients' sleep quality, as evidenced by a significant increase in Richards-Campbell Sleep Questionnaire scores from 62 (IQR = 48-72) to 70 (IQR = 62-76) (95% CI [-10.000, -6.000], Z = -6.100, p < .001). Nurses demonstrated a 100% agreement in knowledge items and a significant upsurge in action items following the intervention. Concurrently, adherence to practice standards showed notable improvements in sleep management practices, including enhanced sleep quality assessment, daytime functional exercise support and compliance with environmental regulations, along with increased use of earplugs, eye masks and aromatherapy/music therapy.
Conclusions: The study highlights the effectiveness and feasibility of a nurse-led sleep management strategy, as demonstrated by improved patient outcomes and increased nurse adherence to sleep promotion interventions.
Relevance to clinical practice: The significant improvements in sleep quality as well as the increased adherence to evidence-based interventions by nurses suggest that this SLEEP Bundle could be effectively translated to other clinical settings.
期刊介绍：
Nursing in Critical Care is an international peer-reviewed journal covering any aspect of critical care nursing practice, research, education or management. Critical care nursing is defined as the whole spectrum of skills, knowledge and attitudes utilised by practitioners in any setting where adults or children, and their families, are experiencing acute and critical illness. Such settings encompass general and specialist hospitals, and the community. Nursing in Critical Care covers the diverse specialities of critical care nursing including surgery, medicine, cardiac, renal, neurosciences, haematology, obstetrics, accident and emergency, neonatal nursing and paediatrics.
Papers published in the journal normally fall into one of the following categories:
-research reports
-literature reviews
-developments in practice, education or management
-reflections on practice
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