Emily Owen, BCCCP, BCPS, MS
Clinical Pharmacy Specialist
Barnes-Jewish Hospital
Saint Louis, MO
Disclosure information not submitted.
Carrie Sona, BSN, CCNS, CCRN, MSN
Clinical Nurse Specialist
Barnes Jewish Hospital
Saint Louis, MO
Disclosure information not submitted.
Emily Ferrera, BSN, RN
Critical Care Nurse
Barnes-Jewish Hospital, United States
Disclosure information not submitted.
Bruno Maranhao, MD, PhD
Fellow
Washington University in Saint Louis School of Medicine, United States
Disclosure information not submitted.
Sarah Smith, PhD, MD
Physician
Washington University in St. Louis, Missouri, United States
Disclosure information not submitted.
Title: Impact of a sleep hygiene bundle on sleep quality in the ICU
Introduction: Lack of sleep is associated with adverse outcomes. Sleep quality in the ICU has been shown to be fragmented due to pain, anxiety, noise, light, and frequent arousal for care activities. Sleep hygiene bundles have been introduced in many ICUs with varying levels of impact.
Methods: This QI project was completed in the 36-bed surgery/trauma/burn ICU at Barnes-Jewish Hospital, a quaternary referral center in St. Louis, MO. A sleep quality survey was developed and administered to patients via a text link to the bedside RN phone using Qualtrics software. The Richards-Campbell Sleep Questionnaire was used and includes elements relating to ease in falling asleep, sleep quality, awakening and return to sleep. Additionally, patients were surveyed on the offering and acceptance of eye masks, ear plugs, and turning off the TV. After a baseline survey period of 4 weeks, an educational intervention on the importance of sleep and sleep hygiene bundle to include eliminating screens, administering prn medications, ear plugs and eye masks, bundling care with labs/CXR before 2200, reduced VS monitoring when able was introduced. Patients were surveyed again post intervention for a 4 week period.
Results: A total of 248 patients were able to complete the survey among the 3 survey periods (135 in the pre-implementation period (P1), 39 in the implementation (P2), and 74 in the post-implementation period (P3)). Significantly more patients were offered eye masks [P1: 15%, P2: 23%, P3: 31%; p=0.023)], ear plugs (P1: 13%, P2:18%, P3: 30%; p=0.002), and turning the TV off (P1: 86%, P2: 100%, P3: 89%; p=0.030). No differences were noted among any of the factors on the RCSQ sleep scale across the time periods.
Conclusions: Education on the importance of sleep hygiene in the ICU and non-pharmacological options for sleep improved the offering of eye masks, ear plugs, and turning the TV off in a SICU. The use of a survey sent to the RN using their work smart phone device provided a novel way to gather data.