Table 2. Implementation of Sleep Quality Improvement Interventions.
| Intervention | Completion |
|---|---|
| Patient daytime interventions (N=735 patient-days), n (%)a,b | |
| Blinds raised | 578 (79) |
| Caffeine avoided after 3pmc | 248 (54) |
| Less than 50% of day shift spent nappingd | 287 (45) |
| Patient nighttime interventions (N=826 patient-nights), n (%)a | |
| Room lights dimmed before 10pm | 642 (78) |
| Room curtain closed before 10pm | 528 (64) |
| Warm bath before 10pm | 403 (49) |
| Unnecessary alarms prevented | 640 (77) |
| Room temperature optimized | 637 (77) |
| Pain appropriately controlled | 559 (68) |
| Television off | 486 (59) |
| Estimated number of nurse interruptions between 10pm-7am | |
| 0-5 interruptions | 231 (28) |
| 6-10 interruptions | 177 (21) |
| >10 interruptions | 111 (13) |
| Not reported | 307 (37) |
| Soft music offered and acceptede | 62 (11) |
| Eye mask offered and acceptede | 10 (2) |
| Earplugs offered and acceptede | 5 (1) |
| Medication given per sleep guidelinef | 61 (13) |
| ICU-wide nighttime interventions (N=88 days), n (%) | |
| Hallway lights dimmed by 10pm | 78 (89) |
| Overhead pages after 10pm | |
| None | 13 (15) |
| 1-3 | 32 (36) |
| >3 | 7 (8) |
| Unknowng | 36 (41) |
Abbreviations: ICU, Intensive Care Unit
Missing data for individual checklist items occurred for 6-15% of patient-days. In calculating proportions for checklist item adherence, items with missing data were considered not completed.
Excludes 91 patient-days that occurred on day of MICU admission, after daytime interventions could be performed.
Proportion calculated after exclusion of 278 patient-days (38%) where patients’ clinical status prohibited oral intake.
Proportion calculated after exclusion of 92 (13%) patient-days where activities to promote wakefulness were not promoted due to sedation status (RASS −4 or −5).
Proportions calculated after exclusion of 260 (31%) patient-days where nonpharmacologic interventions were not applicable due to sedation status (RASS −3, −4 or −5). Soft music, eye masks, and earplugs were offered but declined by patients 159 (28%), on 150 (27%), and 150 (27%) patient-days, respectively, and not offered to patients (due to patient already sleeping, clinical instability, other clinical duties) on 280 (49%), 323 (57%), and 326 (58%) patient-days.
Medications included low-dose antipsychotics and zolpidem for patients with and without delirium, respectively.
Unknown because staff not present to complete the checklist, or the checklist not completed.