How Sleep Patterns of Patients Are Critical for Nurses

Flick et al., 2010
To determine nurses awareness that activities can reduce daytime sleepiness for patients and increase the quality of sleep during the night in nursing homes and the consequences of this awareness
Case-control study
32 nurses and caregivers, 10 nursing homes in Berlin Germany
8 of the participants understood time structure in the ward determines sleep, 16 understood but did not take advantage of this to influence resident’s sleep, and 8 were oblivious of the link between time structure and sleep.
Poor knowledge on the link between time structure and sleepiness by nursing home staff might be one of the causes of limited sleep by the residents. The authors concluded there is a need for training of nurses and caregivers on the issues.
Brown, Rutherford & Crawford, 2015
To document the role of noise in mental healthcare giving environments and the extent to which researchers have explored sound in hospitals, and identify new research opportunities.
Narrative review
Data was from UK policy documents and literature search of PubMed, Scopus, and Web of Knowledge.
Unwanted health is detrimental to recovery and this is understood by policymakers in the UK context. The authors contend that there is a need to think about the social functions of sound in mental health clinics
While unwanted sound is stressful, sound can also be useful, soothing, a source of information, and assurance. In mental healthcare environment, sound can be used to secure a degree of manageability, control, and order in the mental health environment.
Rahman & Schnelle, 2002
Research on common sense strategies that can be used to improve sleep for residents in nursing homes, but not commonly used.
Feature article
N/A
N/A
Common sense interventions e.g. individualized nighttime care, educating homecare staff, and noise and light avoidance and removal have a high potential in improving nighttime sleep environment for the majority of nursing home residents. These interventions implemented together are a good step in the right direction towards ensuring a good night sleep for nursing home residents.
Kamdar et al., 2016
To evaluate and determine the perceptions and practices of providers concerning sleep in the intensive care unit.
Prospective cohort study
The sample was made up of critical care clinicians including physicians, physician assistants, nurses, and nurse practitioners from north America, South America, Europe, Asia, and Australia working in ICU with at least 6 beds.
Out of 1223 participants from 24 counties; 75% indicated ICU patients experienced very poor or poor sleep, 88% indicated poor sleep affected recovery, 97% associated poor sleep with negative ICU results, 88% associated poor sleep with longer ICU stay, 87% associated poor sleep with poor participation is physical therapy, and only 32% had implemented sleep-improvement protocols.
There is a wide gap between the perceptions care providers have and the practices surrounding sleep in the ICU and there is a lack of available guidelines that are supported by evidence on how to promote sleep in the ICU.
Radtke, Obermann & Teymer, 2014
To identify the knowledge nurses had on sleep quality outcomes for acutely ill patients, nurses understanding on the negative effects of insomnia, whether knowledge on effects of sleep influence promotion of sleep strategies.
Prospective cohort study
Convenient sample of nurses working in general and surgical units from a 321-bed home care in central Wisconsin.
Nurses had knowledge to recognize the effects of insomnia, there was no deficit on knowledge on how sleep quality promotes healing, and the knowledge on the benefits associated with adequate sleep did not promote the adoption of sleep promotion activities.
Even though nurses have the relevant knowledge on the effects of insomnia and the benefits of adequate sleep in acutely ill patients, barriers still exist to adoption of strategies to promote enough sleep.
Gilenan, 2012
An examination of normal and insomnia sleep patterns and what nurses can do to determine sleep disturbances and the strategies to promote adequate sleep in inpatients and care home residents.
Systematic review
Literature search from MEDLINE, CIHAHL, and PubMed using the keywords “health promotion,” “sleep,” and “inpatients.”
Inclusion criteria: literature on older people, post-surgery, cancer patients, the critically ill, and pregnant women.
N/A
Insomnia is widespread and often goes undiagnosed. Insomnia affects recovery, length of stay, and patient general wellbeing. Nurses should promote good sleep habits because it is also benefiting to nurses including short-stays.
Nesbitt & Goode, 2014
To explore the knowledge nurses have on sleep and how sleep is prioritized while at the same time examining the use of sleep assessment tool and skills.
Systematic literature review
Literature materials published between 2003 and 2013 search in Cochrane and Science direct databases.
378 articles were identified, and 25 meet the inclusion criteria.
ICU nurses are deficient in knowledge on importance of sleep and interventions to promote sleep. Such interventions are hindered by lack of training and support structures.
McIntosh, 2006
Exploration of educational experiences, attitudes, and experiences of nursing students and registered nurses on promotion of sleep.
Mixed research design
27 pre-registration Higher education institutions, 120 volunteer students, and 98 registered nurses,
No standardization of education input from higher education institutions, information on sleep was from own experiences, participants learning was unstructured, they held generally positive attitudes on sleep but some of it was hindered by attitude of others, ward culture, work schedule, hence low promotion of sleep care.
There is a need to address the acquisition of sleep promotion strategies with a proposed framework. Clinical implications included involving managers who are responsible for promoting positive culture within the clinical environment.

Ongel & Sezgin, 2016
The paper presents a framework for the assessment of health impact through a health impact assessment model for road transportation noise emission.
Case study
Nine municipalities in Istanbul
Application of the model shows that a speed limit of 70km/hr would lead to a gain of 434 healthy years for the residents in the case study municipalities.
The health effects from transportation noise are adverse. Using noise reduction pavements surfaces and speed limit has the potential to improving health risks as a result of transportation noise. Establishment of speed limit maybe a strategy towards reduction of the impacts of noise.

Salzmann?Erikson, Lagerqvist & Pousette, 2016
The study explored experiences by nurses in their efforts to promote sleep for the inpatients.
Empirical qualitative design.
Eight nurses selected purposely from an inpatient hospital in Sweden.
The results showed four categories of sleep promoting strategies are used by nurses; planning and prevention for sleep promotion by nurses, adoption of the sleeping environment to enhance sleeping, using drugs to enhance sleep especially in unfriendly environments, and engaging the patient in a caring conversation to induce peaceful sleeping.
The promotion of sleep through strategies to enhance sleep is vital in the recovery process for patients. The use of simple strategies for reduction of sensory is an effective method for promoting sleep and it reduces the use of drugs to sedate patients.

Brown et al., 2014
To identify gaps in evidence and practice for Healthcare providers in the management of sleep and dementia so at to promote the translation of knowledge strategies and facilitate better management of persons with dementia.
Case control study design
National and provincial healthcare provider associations and organizations in Canada sources from internet search then snowballed.

1846 participant’s majority from rehabilitation and nursing. Participants understated incidences of sleep deficiencies for persons with dementia and didn’t understand the relationship between amnesia and dementia. Knowledge on sleep assessment tools was limited to work reports. There was limited knowledge on dementia and comorbid conditions. Nonpharmacological sleep intervention used where regular routine for sleeping, more daytime activity, and reduced caffeine were used with low knowledge on other methods.
Healthcare providers have diverging knowledge or knowledge gaps on sleep management for persons with dementia.

Gellerstedt et al. 2015
To describe the experiences of nurses on patient sleep in an emergency hospital and nurses’ perceptions on promoting sleep interventions to use.

Qualitative descriptive design
22 nurses selected through convenience sampling from 4 hospitals in Stockholm.
Nurses desired to promote patients sleep. Emergency hospitals are not organized as per patient needs. Nurses in emergency care don’t have opportunities to promote patient’s sleep behavior. Several nurses stated they didn’t have enough knowledge on promoting patient’s sleep. Nurses emphasized on the importance of patient sleep and the need to prioritize it.
Nurses have limited knowledge on intervention to promote sleep. Current interventions are commonsense and personal experiences not evidence-based. Sleep in nursing needs more development and focus for nurses to deliver in emergency hospitals.


Deutschman, 2005
To identify some particular aspects of how nursing homes are organized so as to provide a problem-solving start-point.
Cross-sectional study
Observation of staff in three nursing homes; suburban proprietary Alzheimer unit of 44 ambulatory residents all semi-private, suburban non-profit dementia unit with 39 residents in private and double room, and urban non-profit dementia unit with 44 residents.
The findings were on facility’s routine, recruitment and training, teamwork activities and leadership, role-modeling and mentor services, satisfaction by staff and residents, week staff and activities, sharing of best practices, and bureaucratic structure.
To change the values, intervention should start with the administrators and owners to focus on new relationships with all stakeholders.










References
Brown, B., Rutherford, P., & Crawford, P. (2015). The role of noise in clinical environments with particular reference to mental health care: A narrative review. International journal of nursing studies, 52(9), 1514-1524.
Brown, C. A., Wielandt, P., Wilson, D., Jones, A., & Crick, K. (2014). Healthcare providers’ knowledge of disordered sleep, sleep assessment tools, and nonpharmacological sleep interventions for persons living with dementia: A national survey. Sleep disorders, 2014.
Deutschman, M. T. (2005). An ethnographic study of nursing home culture to define organizational realities of culture change. Journal of Health and Human Services Administration, 246-281.
Flick, U., Garms-Homolová, V., & Röhnsch, G. (2010). ‘When They Sleep, They Sleep’ Daytime Activities and Sleep Disorders in Nursing Homes. Journal of health psychology, 15(5), 755-764.
Gellerstedt, L., Medin, J., Kumlin, M., & Rydell Karlsson, M. (2015). Nurses' experiences of hospitalised patients' sleep in Sweden: a qualitative study. Journal of clinical nursing, 24(23-24), 3664-3673.
Gilsenan, I. (2012). Nursing interventions to alleviate insomnia: Many people experience problems sleeping as they get older. Irene Gilsenan describes some practical strategies that nurses can use to help patients achieve a good night’s rest in hospital. Nursing older people, 24(4), 14-18.
Kamdar, B. B., Knauert, M. P., Jones, S. F., Parsons, E. C., Parthasarathy, S., & Pisani, M. A. (2016). Perceptions and Practices Regarding Sleep in the Intensive Care Unit. A Survey of 1,223 Critical Care Providers. Annals of the American Thoracic Society, 13(8), 1370-1377.
McIntosh, A. E. (2006). A qualitative and quantitative study of registered and student nurses' educational experiences, knowledge and attitudes regarding sleep promotion in hospital (Doctoral dissertation, Edinburgh Napier University).
Nesbitt, L., & Goode, D. (2014). Nurses perceptions of sleep in the intensive care unit environment: A literature review. Intensive and critical care nursing, 30(4), 231-235.
Ongel, A., & Sezgin, F. (2016). Assessing the effects of noise abatement measures on health risks: A case study in Istanbul. Environmental Impact Assessment Review, 56, 180-187.
Radtke, K., Obermann, K., & Teymer, L. (2014). Nursing knowledge of physiological and psychological outcomes related to patient sleep deprivation in the acute care setting. Medsurg nursing, 23(3), 178.
Rahman, A. & Schnelle, J. (2002). Strategies for improving residents’ nighttime sleep. Nursing homes long term care management, 63-67.
Salzmann?Erikson, M., Lagerqvist, L., & Pousette, S. (2016). Keep calm and have a good night: nurses' strategies to promote inpatients' sleep in the hospital environment. Scandinavian journal of caring sciences, 30(2), 356-364.