Date of Award

Spring 4-7-2021

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Dr. Sheri Jocobson

Second Advisor

Dr. Sandra Swearingen


Practice Problem: Delirium is a common, yet often preventable complication in hospitalized patients. It is often caused by fragmented sleep, medications, environmental stimuli, and treatment therapies.

PICOT: The PICOT question that guided this evidence-based practice change project was: For patients in an adult Intensive Care Unit (ICU), does using a nurse-initiated, non-pharmacological sleep-enhancement protocol, versus no sleep-enhancement protocol, reduce the incidence of ICU-delirium over a period of 2 months?

Evidence: The reviewed literature supported the evidence for effective use of a nurse-initiated protocol in reducing delirium in the ICU. Sixteen articles met the inclusion criteria for the review of literature that supported the DNP project.

Intervention: A nurse-initiated sleep-enhancement protocol was implemented, which reduced interruptions during the hours between midnight and 0400.

Outcome: While there was a 50% reduction in delirious patients after the protocol was initiated, the data pool was small and was not proven to be statistically significant. Due to the Covid-19 outbreak, there were far fewer eligible patients than originally anticipated.

Conclusion: Although a clinically significant project outcome was not realized, staff felt that the protocol improved patient care and advocated for its use on all patients as a standard of care. Unit-based shared governance councils on other acute care floors have also adopted the sleep enhancement protocol


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

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