scholarly journals Promoting Sleep in the Intensive Care Unit

2020 ◽  
Vol 6 ◽  
pp. 237796082093020
Author(s):  
Jorunn Beck Edvardsen ◽  
Fredrik Hetmann
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Care ◽  
Cochrane Library ◽  
Critical Care Nursing ◽  
Quiet Time ◽  
Medical Subject Headings ◽  
Intensive Care Nurses ◽  
Intensive Care Patients ◽  
Nonpharmacological Intervention

Introduction Intensive care nurses face several challenges to facilitating sleep in their critically ill patients. With its high noise levels, hectic around-the-clock activity and constant artificial lights, the intensive care environment does not foster sleep. Intensive care unit patients have significant alterations in their sleep architecture with frequent awakenings and lighter sleep; up to 50% of this sleep also occurs during the daytime. Sleep loss increases the risk of developing delirium (especially in elderly patients) and immune system impairment, which prolongs healing. The aim of this article was to develop an evidence-based bundle of nursing care activities that promote adult intensive care patients’ sleep. Methods A broad search was conducted in PubMed, CINAHL, Cochrane Library, and McMaster plus using search words and Medical Subject Headings terms, such as sleep, intensive care unit, intensive care, critical care nursing, sleep promotion, music, white noise, earplugs, pain relief, absence of pain, nonpharmacological intervention, and mechanical ventilation. Eight recommendations emerged from this review: reduce noise, use earplugs and eye masks, use music, promote a natural circadian rhythm, manage pain, use quiet time, cluster nursing care activities at night, and optimize ventilator modes. Conclusion Promoting sleep within this patient population needs to be a higher priority for intensive care nurses. Sleep should be a focus throughout the day and night, in order to sustain patients’ natural circadian rhythms. Novel research in this field could change the strength of these recommendations and add new recommendations to the bundle.

scholarly journals Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Riitta-Liisa Lakanmaa ◽  
Tarja Suominen ◽  
Marita Ritmala-Castrén ◽  
Tero Vahlberg ◽  
Helena Leino-Kilpi
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Nursing Care ◽  
Critical Care Nursing ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Competence Scale ◽  
Intensive Care Unit Nurses ◽  
Care Nursing

Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1–5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n=431). Intensive care unit nurses’ self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses’ basic competence was their experience of autonomy in nursing care (Fvalue 60.85,β0.11, SE 0.01, andP≤0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses’ experienced autonomy in nursing.

scholarly journals The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: an observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
L. J. Delaney ◽  
E. Litton ◽  
K. L. Melehan ◽  
H.-C. C. Huang ◽  
V. Lopez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Moderate Level ◽  
Sleep Monitoring ◽  
Clinical Trial Registration ◽  
Wake Time ◽  
Intensive Care Patients

Abstract Background Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. Results We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland–Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number ACTRN12615000945527 (Registered 9/9/2015).

scholarly journals Using a behavior analytics approach to change nursing care of extremely premature infants: A pilot study

2018 ◽  
Vol 9 (5) ◽  
pp. 14
Author(s):  
Jenn Gonya ◽  
Jessica Niski ◽  
Nicole Cistone
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Neonatal Intensive Care Unit ◽  
Premature Infant ◽  
Premature Infants ◽  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Extremely Premature Infant

The neonatal intensive care unit (NICU) is, inherently, a trauma environment for the extremely premature infant. This trauma is often exacerbated by nurse caregiving practices that can be modified and still remain effective. Our study explored how behavior analytics could be used to implement an intervention known as Care by Cues and how the intervention might, ultimately, impact infant physiologic stability.

The Effect of Nocturnal Patient Care Interventions on Patient Sleep and Satisfaction With Nursing Care in Neurosurgery Intensive Care Unit

2015 ◽  
Vol 47 (2) ◽  
pp. 104-112 ◽  
Author(s):  
Gülay Altun Uğraş ◽  
Sultan Babayigit ◽  
Keziban Tosun ◽  
Güler Aksoy ◽  
Yüksel Turan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Patient Care ◽  
Nursing Care

Design and psychometric testing of instruments to measure qualified intensive care nurses’ attitudes toward obese intensive care patients

2018 ◽  
Vol 41 (6) ◽  
pp. 525-534 ◽  
Author(s):  
Nastasja Robstad ◽  
Frank Siebler ◽  
Ulrika Söderhamn ◽  
Thomas Westergren ◽  
Liv Fegran
Keyword(s):  
Intensive Care ◽  
Psychometric Testing ◽  
Intensive Care Nurses ◽  
Intensive Care Patients

scholarly journals ASSISTÊNCIA DE ENFERMAGEM NOS CUIDADOS PALIATIVOS AO PACIENTE IDOSO EM UNIDADE DE TERAPIA INTENSIVA / NURSING CARE IN PALLIATIVE CARE FOR ELDERLY PATIENTS IN AN INTENSIVE CARE UNIT

2020 ◽  
Vol 6 (12) ◽  
pp. 102261-102281
Author(s):  
Airton César Leite ◽  
Jaiciane Jorge da Silva ◽  
Maria Merciane Medeiros do nascimento Ferreira ◽  
Vanessa Bonfim Mendes ◽  
Lianna Emanuelli Carvalho Silva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Elderly Patients ◽  
Nursing Care ◽  
Terapia Intensiva

scholarly journals Association between early mobilization or rehabilitation and intensive care unit acquired weakness: A systematic review and meta-analysis of randomized controlled trials.

2020 ◽  
Author(s):  
Minghang Li ◽  
Mingyue Ding ◽  
Huanzhang Shao ◽  
Bingyu Qin ◽  
Xingwei Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Meta Analysis ◽  
Early Mobilization ◽  
Standard Of Care ◽  
Cochrane Library ◽  
Care Group ◽  
China National Knowledge Infrastructure ◽  
Number Of Patients ◽  
Icu Discharge

Abstract Background The prognosis of intensive care unit acquired weakness (ICUAW) is poor and the treatment effect is not ideal. At present, some effective and safe early prevention means are urgently needed to reduce its incidence.This study evaluated the effectiveness and safety of early activities or rehabilitation in the prevention of ICUAW. Methods We searched for articles in five electronic databases, including PubMed, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI) and Wanfang Med Online. All publications until June, 2020 were searched. We have selected trials investigating early mobilization or rehabilitation as compared to standard of care in critically ill adults.The extracted data included adverse events, the number of patients with ICUAW, the length of stay in the ICU (ICU-LOS) the length of mechanical ventilation (MV) etc. Results The final results showed that compared with the usual care group, early mobilization or rehabilitation reduced the prevalence of ICUAW (RR, 0.73; [0.61, 0.87]; I2 = 44%; P = 0.0006), ICU-LOS (MD, − 1.47;[2.83, 0.10]; I2 = 56%; P = 0.04), length of MV (MD, − 1.96; [2.41, 1.51]; I2 = 0%; P = 0.00001), but the mortality (RR, 0.90; [0.62, 1.32]; I2 = 3%; P = 0.60) at ICU discharge was not associated. The subgroup analysis of ICUAW prevalence and ICU-LOS based on the intervention methods showed that early combined rehabilitation could reduce the prevalence of ICUAW (RR, 0.56; [0.43, 0.74]; I2 = 34%; P = 0.0001) and shorten the ICU-LOS (MD, − 2.21; [3.28, 0.97]; I2 = 23%; P = 0.0003). EGDM was not associated with a decrease in ICUAW prevalence (RR, 0.85; [0.65, 1.09]; I2 = 26%; P = 0.20), but it reduced the ICU-LOS (MD, − 2.27; [3.86, 0.68]; I2 = 0%; P = 0.005).Early in-bed cycling was not associated with reduced ICUAW prevalence(RR, 1.25; [0.73, 2.13]; I2 = 0%; P = 0.41) and ICU-LOS(MD, 2.27; [0.27, 4.80]; I2 = 0%; P = 0.08) . Conclusions Early mobilization or rehabilitation was associated with a shorter length of MV and ICU-LOS, but not mortality. Of course, not all early activities or forms of rehabilitation are effective. The early combined rehabilitation model is effective for the prevention of ICUAW. However, EGDM and early in-bed cycling were not effective in preventing ICUAW.

scholarly journals A HOSPITALIZAÇÃO DO ADOLESCENTE NA ÓTICA DOS PROFISSIONAIS DE ENFERMAGEM

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Nathália Da Silva Pimentel Reis ◽  
Maria Fabiane Galdino Dos Santos ◽  
Inez Silva De Almeida ◽  
Helena Ferraz Gomes ◽  
Dayana Carvalho Leite ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Care ◽  
Medical Records ◽  
Rio De Janeiro ◽  
Descriptive Study ◽  
Tertiary Hospital ◽  
Legal Aspects ◽  
Quantitative Approach ◽  
Patient Identification

Objetivo: Compreender a ótica dos profissionais de enfermagem sobre a hospitalização de adolescentes. Metodologia: Pesquisa qualitativa, descritiva, utilizando entrevista com perguntas semi-estruturadas, realizada em uma enfermaria especializada em saúde do adolescente no Rio de Janeiro, no período de fevereiro a abril de 2016, com 15 profissionais de enfermagem. Resultados: A partir da análise de conteúdo de Bardin, definiram-se três categorias: a inexperiência no cuidado de enfermagem ao adolescente como um desafio, especificidades da adolescência, e sentimentos gerados pela hospitalização do adolescente no profissional de enfermagem. Conclusão: Conclui-se que os profissionais de enfermagem se colocaram inexperientes em cuidar desse público e declararam que o cuidado a essa população é um desafio para a equipe.Descritores: Adolescente, Enfermagem, Hospitalização.THE ADOLESCENT’S HOSPITALIZATION IN THE OPTICS OF NURSING PROFESSIONALSObjective: Analyze the contents of nursing notes in patients’ records in an intensive care unit (ICU) of a public tertiary hospital in Fortaleza, CE. It is a descriptive study with quantitative approach that analyzed 151 medical records of patients admitted to an ICU, from September 2014 to February 2015, whose 48 hour and discharge notes were evaluated. Data revealed notes with poor content, which did not express the patients’ situation, nor the nursing care provided. Data concerning date, time, and patient identification were adequate. However, the COREN number and the professional’s signature raised concern given the high percentage of non-compliance regarding ethical and legal aspects. Nursing notes did not reflect the severity of patients, nor the dynamics in the ICUDescriptors: Adolescent, Nursing, HospitalizationADOLESCENTE EN PERSPECTIVA DE LOS PROFESIONALES DE ENFERMERÍAComprender la óptico del profesional de enfermería de hospitalización de los adolescentes. Metodología: cualitativos, investigación descriptiva, utilizando entrevistas con preguntas semi-estructuradas en una sala especializada para la salud de los adolescentes en Río de Janeiro, en el período de febrero a abril 2016 con 15 profesionales de enfermería. Resultados: A partir del análisis de contenido de Bardin, definido tres categorías: la falta de experiencia en la atención de enfermería a la adolescente como un desafío, características de los adolescentes y los sentimientos generados por la hospitalización de los adolescentes en profesionales de enfermería. Conclusión: Se concluye que los profesionales de enfermería se colocaron inexpertos en cuidar de ese público y declararon que el cuidado a esa población es un desafío para el equipo.Descriptores: Adolescente, Enfermería, Hospitalización

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