Improving the Quality of Sleep in ICU Patients With a "Sleep Bundle"
试验速览
- 阶段
- 不适用
- 入组人数
- 130
- 主要终点
- Improvement of the quality of sleep in ICU patients measured by the Richards Campbell Sleep Questionnaire (RCSQ)
研究概览
简要总结
Summary of the project :
Lack or disturbances of sleep are major problems in patients staying in intensive care unit (ICU) due to the particular environment. The noises, lack of circadian rhythm of light lead to progressive deafferentation. The patients are then at risk of immune deficiencies, agitation and confusion states, cognitive troubles that may be associated to increased morbidity and mortality in the short and long term. Thus, improvement of the sleep of the ICU patients may impact non only during the ICU stay but also on their future quality of life.
The sleep bundle project is a quality improvement project with a before-after design, consisting in the evaluation of a bundle of measures that may increase the quality and duration of sleep in ICU patients.
The bundle consists in the proposition of eye-mask, ear-plugs, music and/or massage to the patients in parallele to structural and organizational modifications of the service such as the decrease of the alarms sounds, changing the luminosity between day and night, etc.
The principal indicators followed will be:
- The sleep quality of the patients
- The continuous noise intensity in the rooms
- The continuous light intensity in the rooms Baseline - before period: 8 weeks Implementation of the bundle with training of the team: 4 weeks After period: 8 weeks.
详细描述
Sleep bundle_detailed project _ English
The patients of intensive care unit (ICU) suffer from sleep disorders or lack of sleep due to the particular environment. Among other problems, the noise, the lack of circadian variation of the light lead to a progressive temporal and spatial disorientation. The patients then are subject to a modification of their immunity, present agitation and confusion, neurocognitive disorders with consequences on the morbidity and the short and long-term mortality. An improvement of the sleep of the patients staying in the intensive care will have potentially an impact not only during the stay in the service but also for their future quality of life.
The project " sleep bundle " aims at improving the sleep of the patients by the implementation of a multimodal intervention that consists in a set of measures (or bundle) at different levels: on a structural level in the service), organizational and individual care of the patients.
The intervention, called "sleep bundle" will be proposed to each ICU patient at the bedtime: ear plugs, a mask for eyes, the listening of a soft music, a massage. The whole service structure and organization will be modified by: the installation of a bright light in the daytime and avoidance of light or dark at night, education of the medical and nurse staff in order to increase the awareness of the paitents needs (i.e. limit the light during the night by the use of a shadowless illumination during the night care), a protocol to adapt the volume of the alarms, the implementation of trash cans with shock absorber of lid in every cubicle, the presence of viewable clocks by all the patients (temporal orientation), recalling the necessity of giving to the patients their glasses and hearing aids during daytime.
Design of the project and methodology: this project is a Quality improvement project with the classical BEFORE and AFTER approach. It will measure some quantitative measures and indicators before and after the implementation of the intervention, i.e. the sleep bundle.
研究设计
- 研究类型
- Interventional
- 干预模型
- Sequential
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 17 Years 至 —（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients (≥ 18 yo),
- •Hospitalised for ≥ 24h in ICU
- •Planned stay of more than 1 day
- •After termination of sedation
- •Glasgow ≥ 12, SAS ≥ 3-4, CAM-ICU negative
排除标准
- •patients with neueological disease or neurosurgery requiring neurological assessment every 4hours or more
研究组 & 干预措施
Cohort study (Before-after desgin)
Quality improvement - sleep bundle Intervention consists in a sleep bundle, an aggregate of several propositions to improve the sleep of patients.: implementation of a sleep bundle.
The entire ICU population will be observed before and after intervention.
干预措施: Quality improvement - sleep bundle (Other)
结局指标
主要结局
Improvement of the quality of sleep in ICU patients measured by the Richards Campbell Sleep Questionnaire (RCSQ)
时间窗: 6 months
Before-after design aiming at increasing the Richards Campbell Sleep Questionnaire (RCSQ) of ICU patients.
次要结局
- agitation episodes(6 months)
- delirium(6 months)
- patient related incident(6 months)
研究者
Pr. Bara RICOU
Professor
University Hospital, Geneva