Date Presented 03/21/24

A need for a sleep hygiene protocol in the intensive care unit (ICU) was identified to improve patient outcomes. An interdisciplinary survey was used to explore perspectives of sleep hygiene and current practices in the medical ICU (MICU) to guide further research.

Primary Author and Speaker: Susan E. Whitworth

Additional Authors and Speakers: Krista Garrison

In the medical intensive care unit (MICU), critically ill patients frequently encounter poor sleep quality due to a combination of various factors and barriers that hinder their ability to attain restorative sleep (Kamdar et al., 2013). Inadequate sleep in the ICU not only poses challenges to patient comfort but also increases the risk of developing delirium and adversely affects their recovery outcomes. Currently, the MICU at Pennsylvania Hospital (PAH) lacks established sleep hygiene protocols, despite the evident necessity for such measures. To address the pressing need for sleep hygiene protocols in the MICU and improve patient outcomes, an interdisciplinary team approach is vital. To gain insight into the interdisciplinary team’s knowledge of and current practices on sleep hygiene, a 10- question survey consisting of quantitative and qualitative data was distributed. Over a 1-month period (May 2023) a survey was distributed to MICU staff via email, attending rounds, and signage placed in staff lounges. 32 members of the interdisciplinary team completed the survey. Results highlighted the most common sleep disruptions were due to medical interventions (59%). A majority of respondents observed a relationship between poor sleep quality and likelihood of experiencing delirium (63%), lack formal education on sleep practices (72%) and believe a formalized protocol would be valuable (97%). In conclusion, the survey results reveal the need for implementing an interdisciplinary sleep hygiene protocol to enhance patient outcomes in the MICU, considering the common sleep disruptions, the association with poor sleep quality and delirium, and the lack of formal education on sleep practices. The findings of this study highlight the potential impact of environmental supports, cognitive intervention strategies, and the creation of practice guidelines for sleep practices in the MICU, all of which have the potential to enhance patients' occupational participation.

References

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Kamdar, B. B., Yang, J., King, L. M., Neufeld, K. J., Bienvenu, O. J., Rowden, A. M., Brower, R. G., Collop, N. A., & Needham, D. M. (2014). Developing, implementing, and evaluating a multifaceted quality improvement intervention to promote sleep in an ICU. American Journal of Medical Quality : The Official Journal of The American College of Medical Quality, 29(6), 546–554. https://doi.org/10.1177/1062860613509684