With the progress of the intense medicine, over the past ten years there has been documented more and more patients/clients who have survived a critical illness. Intensive care unit admission is a great source of somatopsychological burden to the patient/client. One of the main aspects of the negative experience is a quality of sleep which is subjectively perceived as low. This master thesis summarizes the knowledge of a current research which is dealing with the causes of poor sleep quality on the intensive care department. It offers a detailed overview of environmental and physiological factors which are related to the poor quality of sleep. It contains summary information of the description and recalling dreams. The research of the master thesis is handling searching for factors which predict the poor quality of sleep, and also the factors which predict if a patient/client will recall the dream which they were having. Within our research we executed an exploratory pilot study. In conclusion of the analysis there was a discovery of a deteriorative sleep quality by perceiving heat discomfort. We were also observing the trend of a deteriorative sleep quality by the connection to the mechanical ventilation, but only when not provided sedation. The result of the research are follow-up research...

Det är väl belagt att patienter postoperativt och inom intensivvården drabbas av en funktionell sömnbrist i form av störd dygnsrytm, stort antal uppvaknanden och rubbad sömncykel med underskott av djupsömn och REM-sömn. En delförklaring till sömnbristen är de generellt höga ljudnivåerna på intensivvårdsavdelningar. Syftet med föreliggande pilotstudie var att undersöka huruvida öronproppar kunde förbättra den upplevda sömnkvalitén för patienter inom intensivvård och postoperativt. Tjugotvå patienter från två intensivvårdsavdelningar, en hjärtintensivvårdsavdelning och en postoperativ avdelning deltog i studien. I interventions-gruppen sov elva patienter en natt med öronproppar och elva patienter som sov utan öronproppar utgjorde kontrollgrupp. Sömnkvalitén självskattades med hjälp av Richards-Campbells Sleep Questionnaire (RCSQ). Resultatet visade att de patienter som sovit med öronproppar skattade sin sömn som bättre (median RCSQ sömnindex = 81) än kontrollgruppen (median RCSQ sömnindex = 58), men också att andelen patienter på intensivvårds- och postoperativa avdelningar som kan tillgodogöra sig de eventuellt positiva effekterna av öronproppar är begränsad. / It is a well established fact that patients postoperatively and in intensive care frequently suffer from a functional sleep deprivation in the form of disturbed circadian rhythm, large number of awakenings and disturbed sleep cycle with a deficit of slow wave sleep and REM sleep. A partial explanation for the lack of sleep has been shown to be the high noise levels in intensive care and recovery rooms. The purpose of this pilot study was to examine whether earplugs could improve intensive care and post-operative patients' perceived sleep quality. Twenty-two patients from two intensive care units, a cardiac intensive care unit and a post-surgical department participated in the study. In the intervention group eleven patients spent one night with earplugs, and eleven patients that slept without earplugs formed control group. The patients self-estimated their sleep by using the Richards-Campbell Sleep Questionnaire (RCSQ). The results showed that patients who slept with earplugs rated their sleep as better (median RCSQ sleep index = 81) than the control group (median RCSQ sleep index = 58), but also that the proportion of patients in intensive and post-operative care that can benefit from the potentially positive effects of earplugs is limited.

Sleep deprivation is a multifactorial phenomenon, occurring frequently in the intensive care unit (ICU) and linked to adverse patient healthcare outcomes. The key practice question of this project focused on determining if retiming of routine laboratory and imaging testing outside of the designated “quiet time” can improve sleep quality among adult patients in the ICU. The purpose was to evaluate the effectiveness of implementing an evidence-based intervention to improve sleep quality in the ICU setting. The theoretical framework was the plan-do-study-act model, which offered a process for implementing a practice change and reevaluation of the intervention’s sustainability within the organization. A thorough literature search of over 100 scholarly journal articles, book references, and expert scholarly reports was completed to gain an understanding of this phenomenon in the ICU setting. The Richards-Campbell Sleep Questionnaire (RCSQ) was the data collection tool used to measure improvement in sleep quality. There were 72 participants that are included in the project. The Wilcoxon rank sum and chi square tests were used for the statistical analysis. The findings did not show statistical significance in the improvement in the RCSQ scores after implementation of the intervention. The recommendations include sleep deprivation training for nursing staff and providers, routine use of the RCSQ for data collection, and repeating the study with an increased number of participants and redefined inclusion and exclusion criteria to be more representative of the ICU patient population. The implication for social change is that this project empowers nursing to embrace a leadership role in using evidence-based practice to change clinical guidelines and improve patient outcomes.