Nurse‐led evidence‐based quality improvement programme to improve intensive care unit patient sleep quality
Notice bibliographique
Résumé
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.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,088 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».