An audit of sleep and sedation practices in UK Intensive Care Units

Background Patients in Intensive Care require 24/7 care which results in constant interruptions to patients' sleep pattern. The effects of sleep deprivation impact on patient recovery and healing. Research evidence has identified that noise, nursing or medical procedures, presence of staff or family in room and mechanical ventilation are extrinsic barriers to patient sleep in ICU (Hopper et al 2015). There is limited knowledge regarding the practices to enhance and promote sleep in the United Kingdom. The aim of this study was to undertake an audit of existing practice to determine current sleep and sedation practices in Intensive Care Units (ICU's) across the United Kingdom. Methods An audit of 150 intensive care units across England, Wales and Northern Ireland was conducted as part of a larger international study. The questionnaire was adapted from a previous version developed in the Netherlands (Jose et al 2012) and emailed as a weblink and a word attachment via the Critical Care Network Nurse Lead (CC3N) to unit lead nurses for completion. Data was analysed in Excel. Results Forty-eight ICU's responded to the questionnaire. The units were mainly (Medical and Surgical ) ICU's (78%) which were Intensivist led ICU's (89%). Nurses considered patients sleeping preference (94%) and consulted with patients or family members regarding sleep problems or medications (67%). Environmental interventions such as keeping patients awake during the day (47%), delayed routine blood work until morning (62%) and turned off lights at night (79%) were used to improve sleep. However, non pharmacological intervention such as earplugs (70%) or eye masks (83%) were seldom or never used. Conclusion There is a need for further research to understand the challenges to enhancing sleep and sedation practices in ICU. References Hofhuis J.G.M., Langevoort G., Rommes J.H. and Spronk P.E. (2012) Sleep disturbances and sedation practices in the intensive care unit–A postal survey in the Netherlands. Intensive and Critical Care Nursing, 28, 141—149 Hooper K., Fried T.R. and Pisani M.A. (2015) Health care worker attitudes and identified barriers to patient sleep in the medical intensive care unit. Heart & Lung, 44 (2), 95–99