The effect of a quality improvement intervention on sleep and delirium in critically ill patients in a surgical intensive care unit

Chest. 2021 Mar 24:S0012-3692(21)00548-1. doi: 10.1016/j.chest.2021.03.030. Online ahead of print.ABSTRACTBACKGROUND: Delirium is a deleterious condition affecting up to 60% of patients in the surgical intensive care unit (SICU). Few SICU-focused delirium interventions have been implemented, including those addressing sleep-wake disruption, a modifiable delirium risk factor common in critically ill patients.RESEARCH QUESTION: What is the effect on delirium and sleep quality of a multicomponent non-pharmacological intervention aimed at improving sleep-wake disruption in patients in the SICU setting?STUDY DESIGN AND METHODS: Using a staggered pre-post design, we implemented a quality improvement intervention in two SICUs (general surgery/trauma and cardiovascular) in an academic medical center. After a pre-intervention (baseline) period, a multicomponent unit-wide nighttime (i.e., efforts to minimize unnecessary sound and light, provision of earplugs and eye masks) and daytime (i.e., raising blinds, promotion of physical activity) intervention bundle was implemented. A daily checklist was used to prompt staff to complete intervention bundle elements. Delirium was evaluated twice-daily using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Patient sleep quality ratings were evaluated daily using the Richards-Campbell Sleep Questionnaire (RCSQ).RESULTS: Six hundred and forty-six SICU admissions (332 baseline, 314 intervention) were analyzed. Median [IQR) age...
Source: Chest - Category: Respiratory Medicine Authors: Source Type: research