Marcus T Altman1, Catherine Pulaski2, Francis Mburu2, Margaret A Pisani2, Melissa P Knauert3. 1. Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States. 2. Section of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine; P.O. Box 208057, New Haven, CT 06520-8057, United States. 3. Section of Pulmonary, Critical Care & Sleep Medicine, Department of Internal Medicine, Yale University School of Medicine; P.O. Box 208057, New Haven, CT 06520-8057, United States. Electronic address: melissa.knauert@yale.edu.
Abstract
BACKGROUND: Intensive care unit (ICU) sleep disturbance is severe and potentially related to abnormal light and sound exposure. OBJECTIVES: To assess the prevalence of measures of light and sound disturbance in ICU patient rooms, and whether these could be modified by a sleep-promotion intervention. METHODS: This observational study with a before and after design for a quality improvement initiative surveyed environmental factors in ICU rooms at 01:00 08:00, and 12:00. Surveys assessed light usage, television usage, window shade position, and room door/curtain position. Factors were compared before and after an ICU sleep-promotion intervention. RESULTS: 990 (pre-intervention) and 819 (post-intervention) occupied rooms were surveyed. Pre-intervention, the prevalence of night-time factors included: bright lights on (21%), television on (46%), and room door open (94%). Post-intervention, more rooms had all lights off at night (41% v 50%, p = 0.04), and fewer rooms had open door curtains (57% v 42%, p = 0.001) and window shades (78% v 62%, p = 0.002). CONCLUSIONS: Disruptive environmental factors are common in the ICU. Some factors improve with sleep-promotion interventions.
BACKGROUND: Intensive care unit (ICU) sleep disturbance is severe and potentially related to abnormal light and sound exposure. OBJECTIVES: To assess the prevalence of measures of light and sound disturbance in ICU patient rooms, and whether these could be modified by a sleep-promotion intervention. METHODS: This observational study with a before and after design for a quality improvement initiative surveyed environmental factors in ICU rooms at 01:00 08:00, and 12:00. Surveys assessed light usage, television usage, window shade position, and room door/curtain position. Factors were compared before and after an ICU sleep-promotion intervention. RESULTS: 990 (pre-intervention) and 819 (post-intervention) occupied rooms were surveyed. Pre-intervention, the prevalence of night-time factors included: bright lights on (21%), television on (46%), and room door open (94%). Post-intervention, more rooms had all lights off at night (41% v 50%, p = 0.04), and fewer rooms had open door curtains (57% v 42%, p = 0.001) and window shades (78% v 62%, p = 0.002). CONCLUSIONS: Disruptive environmental factors are common in the ICU. Some factors improve with sleep-promotion interventions.
Authors: Juliana Barr; Gilles L Fraser; Kathleen Puntillo; E Wesley Ely; Céline Gélinas; Joseph F Dasta; Judy E Davidson; John W Devlin; John P Kress; Aaron M Joffe; Douglas B Coursin; Daniel L Herr; Avery Tung; Bryce R H Robinson; Dorrie K Fontaine; Michael A Ramsay; Richard R Riker; Curtis N Sessler; Brenda Pun; Yoanna Skrobik; Roman Jaeschke Journal: Crit Care Med Date: 2013-01 Impact factor: 7.598