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Promoting Sleep in the Intensive Care Unit

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 sig...

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Autores principales: Beck Edvardsen, Jorunn, Hetmann, Fredrik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774495/
https://www.ncbi.nlm.nih.gov/pubmed/33415285
http://dx.doi.org/10.1177/2377960820930209
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author Beck Edvardsen, Jorunn
Hetmann, Fredrik
author_facet Beck Edvardsen, Jorunn
Hetmann, Fredrik
author_sort Beck Edvardsen, Jorunn
collection PubMed
description 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.
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spelling pubmed-77744952021-01-06 Promoting Sleep in the Intensive Care Unit Beck Edvardsen, Jorunn Hetmann, Fredrik SAGE Open Nurs Practice Update 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. SAGE Publications 2020-06-08 /pmc/articles/PMC7774495/ /pubmed/33415285 http://dx.doi.org/10.1177/2377960820930209 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Practice Update
Beck Edvardsen, Jorunn
Hetmann, Fredrik
Promoting Sleep in the Intensive Care Unit
title Promoting Sleep in the Intensive Care Unit
title_full Promoting Sleep in the Intensive Care Unit
title_fullStr Promoting Sleep in the Intensive Care Unit
title_full_unstemmed Promoting Sleep in the Intensive Care Unit
title_short Promoting Sleep in the Intensive Care Unit
title_sort promoting sleep in the intensive care unit
topic Practice Update
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774495/
https://www.ncbi.nlm.nih.gov/pubmed/33415285
http://dx.doi.org/10.1177/2377960820930209
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