Date of Award

2024

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Diane Fuller Switzer

Readers

Laura Crumly

Abstract

Background: Delirium is a prevalent problem in Intensive Care Unit (ICU) patients, affecting up to 80% and resulting in poor outcomes such as increased length of stay in the hospital, prolonged hospitalization, cognitive impairment, and sometimes death. Nonpharmacological therapies, particularly those that promote sleep, have been found to prevent delirium.

Objective/Aim: To determine the efficacy of a nonpharmacological sleep checklist intervention in lowering the incidence of delirium in ICU patients and increasing nurses' knowledge and confidence in the implementation of the sleep bundle/checklist.

Method: A quality improvement project with a pre-post mixed methods design was carried out in a 28-bed ICU. As the primary implementers, nurses were trained extensively on delirium and sleep therapies. Quantitative and qualitative data were assessed to determine the effectiveness of the education given. A nonpharmacological sleep checklist was then implemented for qualified patients for two months to assess the effectiveness of the sleep bundle in reducing ICU delirium emphasizing the critical role of nursing personnel in this process.

Results: Registered nurses (RN) reported enhanced knowledge and confidence following education. Delirium rates dropped from 48.4% pre-implementation to 44.3% after implementation. Staffing concerns and inconsistent documentation were identified as barriers to adoption.

Implications for Practice: Using a nonpharmacological sleep checklist has not only shown encouraging outcomes in lowering delirium rates among ICU patients but also implementation of the sleep bundle checklist has been shown to decrease healthcare costs in the ICU and improve patient outcomes such as functional status. This study emphasizes the significance of continual staff education and assistance for successfully implementing such treatments. Furthermore, it underlines the importance of tailoring interventions to individual patient needs and overcoming implementation challenges in future initiatives, which could improve the quality of care offered.

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