Date of Award
Doctor of Nursing Practice (DNP)
Dr. Sheri Jocobson
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
Thomas, H. (2021). Protecting Sleep to Reduce Delirium in an Adult Intensive Care Unit. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https://doi.org/10.46409/sr.BIGO3616
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.