Steaphen Annamma, Olson DaiWai M, Stutzman Sonja E
Annamma Steaphen, BSN RN CCRN, is Bedside Nurse in the Neurointensive Care Unit at Zale-Lipshy Hospital, University of Texas Southwestern Medical Center, Dallas, TX. DaiWai M. Olson, PhD RN CCRN FNCS, is Associate Professor at the Department of Neurology and Neurotherapeutics and the Department of Neurosurgery, University of Texas Southwestern Medical Center, Dallas, TX.
J Neurosci Nurs. 2017 Oct;49(5):302-306. doi: 10.1097/JNN.0000000000000311.
This quality improvement project aimed to understand the impact of a quiet time protocol on nurses and patients in the neurocritical care unit (NCCU) by comparing pretest and posttest outcomes, taking decibel readings, and abstracting chart information.
Sleep is essential for maintaining a healthy life. Patients in the NCCU often do not get adequate amounts of sleep. Quiet time studies have focused on implementing periods of reduced noise levels to improve patient sleep. However, the perceptions of the caregivers about the protocols have not been taken into consideration, leading to difficulty in implementing these protocols if it impedes with the routine work of the caregivers.
This was a prospective quality improvement project, with a quiet time protocol in the novel setting of the NCCU with caregiver feedback on the protocol. The quiet protocol involved decreasing light, noise, and patient interactions between 11:30 PM and 2:30 AM. There were 16 nurses who consented to the study and provided feedback via self-report questionnaires.
Implementation of this protocol did not suggest a decrease in nurse enjoyment with their job (P = .51). There were significant improvements in patient sleep quality and quantity (P < .0001). In addition, there was some evidence of decrease in the noise level and number of patient disruptions.
The results of this single-site project suggest that, by implementing a quiet time protocol in the NCCU, patients obtained higher levels of sleep quality and quantity. The implementation of this protocol did not impact nurses' job satisfaction, suggesting that the quiet time protocol is possible, improves patients care, and does not hinder nurses' job satisfaction.
本质量改进项目旨在通过比较测试前和测试后的结果、获取分贝读数以及提取图表信息，了解安静时间方案对神经重症监护病房（NCCU）护士和患者的影响。
睡眠对于维持健康生活至关重要。NCCU的患者通常睡眠不足。安静时间研究主要集中在实施降低噪音水平的时间段以改善患者睡眠。然而，尚未考虑护理人员对这些方案的看法，如果这妨碍了护理人员的日常工作，将会导致这些方案难以实施。
这是一项前瞻性质量改进项目，在NCCU的新环境中实施安静时间方案，并收集护理人员对该方案的反馈。安静方案包括在晚上11:30至凌晨2:30之间减少灯光、噪音和患者互动。有16名护士同意参与该研究，并通过自我报告问卷提供反馈。
该方案的实施并未表明护士对工作的满意度下降（P = 0.51）。患者的睡眠质量和时长有显著改善（P < 0.0001）。此外，有证据表明噪音水平和患者干扰次数有所降低。
这个单中心项目的结果表明，通过在NCCU实施安静时间方案，患者获得了更高的睡眠质量和时长。该方案的实施并未影响护士的工作满意度，这表明安静时间方案是可行的，可改善患者护理，且不妨碍护士的工作满意度。
