Improving critical care patients' sleep quality in a surgical high‐dependency unit: An evidence‐based practice project

Abstract Background Sleep is an essential basic need. However, patients in critical care often experience poor and fragmented sleep. As such, there is a need to examine strategies to promote sleep in critical care patients. Aim This project aimed to promote sleep in surgical high‐dependency patients through the implementation of evidence‐based best practice. Methods An evidence‐based practice (EBP) project was implemented in May 2015 in a 24‐bed surgical high‐dependency (progressive care) unit in a public tertiary hospital in Singapore in three phases using the JBI framework. Outcomes measured were sleep quality, using the Richards‐Campbell Sleep Questionnaire, and nurses' adherence to sleep promotion activities, using an audit tool adapted from the JBI‐Practical Application of Clinical Education System. Data were collected at baseline, 1, 3, 6, and 12 months. Getting Research into Practice analysis was done at each time point. Results A total of 120 patients were surveyed, and 150 observation audits were conducted over 1 year. Sleep quality was similar between pre‐audit (mean 53, SD 19.89) and month 1 (mean 54, SD 24.40), improved at month 3 (mean 64, SD 19.34), and sustained at month 6 (mean 64, SD 24.13) and 12 (mean 64, SD 19.4). The effect size between pre‐audit and month 3 was a medium effect size of 0.49, which continued to improve at month 12, with a medium effect size of 0.56. Nurses' adherence to the EBP generally improved, and the thresholds of 80% were exceeded by month 12. Linking Evidence to Action Sleep is an essential basic need and can be improved through simple evidence‐based interventions. Best practice for promoting sleep includes grouping nursing activities and reducing light and noise at night.