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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Nursing in Critical ...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Nursing in Critical Care
Article . 2025 . Peer-reviewed
License: Wiley Online Library User Agreement
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Nurse‐led evidence‐based quality improvement programme to improve intensive care unit patient sleep quality

Authors: Weidi Wang; Xinyan Cao; Jiabin Luan; Qi Zhang; Chun Cai; Juan Han;

Nurse‐led evidence‐based quality improvement programme to improve intensive care unit patient sleep quality

Abstract

Abstract Background Patients in the intensive care unit (ICU) suffer from significant sleep disturbances, which can negatively impact their healing and overall health. Nurses, as the primary caregivers, need to have expertise in sleep management to ensure better patient outcomes. Implementing nurse‐led, evidence‐based sleep protocols in ICUs is crucial. Aim This study aimed to improve ICU patients' sleep quality by developing and implementing a nurse‐led, evidence‐based SLEEP Bundle, including Sleep initiative, Light control, Eye mask and earplugs usage, Environment noise cancellation and Provision of non‐pharmacological (aromatherapy and music therapy) and pharmacological (dexmedetomidine and painkillers) support. Methods The Framework of Evidence‐based Continuous Quality Improvement and the Ottawa Model of Research Use framework were used to guide the development, implementation and assessment of the SLEEP Bundle. A quasi‐experimental study was conducted in a 12‐bed surgical intensive care unit (SICU), assessing patient‐perceived sleep quality, nurses' self‐report knowledge, attitudes and actions regarding patient sleep conditions and nurses' adherence to the interventions. Interventions In order to successfully translate evidence into clinical practice, the protocol was crafted with significant nurse involvement, input in sleep promotion materials and a flexible continuing education component, which provided credits to encourage nurse participation. A sleep‐aid kit, complete with non‐pharmacological tools, and a system of regular quality control and feedback were integral to the clinical application of the protocol. Results The intervention significantly enhanced ICU patients' sleep quality, as evidenced by a significant increase in Richards‐Campbell Sleep Questionnaire scores from 62 (IQR = 48–72) to 70 (IQR = 62–76) (95% CI [−10.000, −6.000], Z = −6.100, p < .001). Nurses demonstrated a 100% agreement in knowledge items and a significant upsurge in action items following the intervention. Concurrently, adherence to practice standards showed notable improvements in sleep management practices, including enhanced sleep quality assessment, daytime functional exercise support and compliance with environmental regulations, along with increased use of earplugs, eye masks and aromatherapy/music therapy. Conclusions The study highlights the effectiveness and feasibility of a nurse‐led sleep management strategy, as demonstrated by improved patient outcomes and increased nurse adherence to sleep promotion interventions. Relevance to Clinical Practice The significant improvements in sleep quality as well as the increased adherence to evidence‐based interventions by nurses suggest that this SLEEP Bundle could be effectively translated to other clinical settings.

Related Organizations
Keywords

Male, Sleep Wake Disorders, Intensive Care Units, Sleep Quality, Humans, Female, Evidence-Based Nursing, Middle Aged, Critical Care Nursing, Quality Improvement

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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