Nurses practices in regard to patient sleep quality
This paper analyses nurses’ practices in relation to patient sleep quality in the ICU. It reviews various articles that document information related to the issue in question. The first article by Castren et al (2014) admits to the fact that patients’ inability to sleep well is one of the most agonizing experiences that nurses witness in the ICU. It thus reviews what nurses have documented in relation to patients’ sleep experience in the ICU, what patients think about sleep as well as how the two categories of people correspond. The design strategy used in this article is cross-sectional survey where nurses’ documentations were gathered from the hospital databases and patients’ responses gathered using the Richard-Campbell Sleep Questionnaire. The sampling plan employed was to include all the night shift nurses as well as patients occupying a mixed ICU with a sixteen-bed capacity. A total of 13 night shift nurses and 114 patients were involved in the study. Participating patients included only those aged eighteen years and above, attentive, devoted, literate, able to communicate in Finnish or Swedish, not having a tracheotomy as well as having slept over night in the ICU. Major findings indicated that nurses’ documentation about patients’ sleep in the ICU was not orderly or complete and it incomprehensively corresponds to patients’ own thoughts about sleep experience.
The second article by Tembo & Parker (2009) establishes that sleep is a crucial process in enhancing quality healing and recovery from critical illness. It therefore investigates on the various factors that influence sleep experience among the ICU patients. The research design employed in the article is literature review, which analyses reports and other materials documenting literature about sleep interruption in the ICU. The sampling plan employed was to include articles printed in English as well as using terms like sleep in ICU, serious illness, sleep interruption as well as Intensive care Units. Three hundred articles were initially identified but were reduced to twenty two, which was achieved through combining concepts as well as targeting those printed since 2000. Out of the twenty-two articles identified, eight comprised of literature reviews, five were qualitative surveys while nine were quantitative surveys. Fourteen of these were printed in America, five in Europe and 3 in Australia. Major findings in the article showed that environmental factors such as noise, nursing contact and procedures, and mechanical ventilation methods were responsible in contributing to patient sleep interruption in the ICU. Intrinsic factors like severity of the illness, drugs used, underlying pain, sedatives used and constant lighting in the ICU also contributed to patients’ sleep deprivation.
The third article by Kamdar et al (2012) admit to the fact that Richard-Campbell Sleep Questionnaire (ROSQ) is an important instrument that can potentially be employed to investigate sleep in the ICU but doubts often arise on the correctness of patients’ rating especially when they are anesthetized or delirious. It therefore investigates the relationship between patients’ and nurses rating on sleep in the ICU. The research design used in the article is an inter-rater evaluation approach where RCSQ questionnaires were used to collect data from patients and nurses. The sampling plan employed included engaging any patient aged eighteen years and above that would spend one entire night in the ICU. This plan was intended to give at least 21 nurse-patient survey pairs. Forty one patients were initially identified but eight of them were excluded for not meeting the inclusion criteria. Only thirty-three patients aged between 46 and 64 years, 61% of whom were female participated in the survey by engaging in ninety-two nurse-patient paired evaluations. Major findings in this article showed that the link between patients’ and nurses’ rating of patient sleep ranged between slight to moderate with a huge proportion of the nurse participants overestimating what patients think about sleep quality.
In summary, it is evident that both intrinsic and environmental factors are responsible in perpetuating sleep deprivation among acutely ill patients in the ICU. Nurses’ perception about sleep in the ICU may however not match the actual patients’ experiences, which explains why the two categories of people can rate the experience differently. Keen observation and the subsequent proper documentation of patients’ sleep in the ICU is however important to enhance creation of proper intervention measures to promote patients’ sleep experience.
Castren, R. et al. (2014). Sleep in the Intensive Care Unit-Nurses’ Documentation and Patients’ Perspective, British Association of Critical Care Nurses, 1:1-9.
Kamdar, B. et al. (2012). Patient-Nurse Interrater Reliability and Agreement of the Richards-Campbell Sleep Questionnaire, American Journal of Critical Care, 21(4):261-268.
Tembo, A and Parker, V. (2009). Factors that Impact on Sleep in Intensive Care Patients, Intensive and Critical Care Nursing, 25: 314-322.