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Developing, implementing, and evaluating a multifaceted quality improvement intervention to promote sleep in an ICU
Biren B Kamdar1, Jessica Yang2, Lauren M King3
1Johns Hopkins University, Baltimore, MD Current affiliation: University of California, Los Angeles, Los Angeles, CA birenk@gmail.com.
Summary
Improving sleep in the intensive care unit (ICU) is crucial for critically ill patients. A quality improvement project implemented a four-step framework to enhance sleep quality through evidence-based interventions and staff engagement.
Area of Science:
- Critical Care Medicine
- Sleep Science
- Quality Improvement
Background:
- Critically ill patients in the intensive care unit (ICU) frequently suffer from poor sleep quality.
- Numerous modifiable factors contribute to sleep disturbances in the ICU environment.
- Addressing sleep quality is essential for patient recovery and well-being in critical care settings.
Purpose of the Study:
- To describe the specific quality improvement (QI) framework utilized for developing and implementing a sleep promotion initiative in a Medical ICU (MICU).
- To provide a detailed account of the QI process to supplement previously published intervention results.
- To establish a replicable model for enhancing sleep in ICU patients.
Main Methods:
- A four-step QI framework was employed: evidence synthesis for interventions, barrier identification and mitigation, performance measure selection, and staff engagement for universal application.
- Performance measures included daily completion rates of sleep improvement checklists (daytime and nighttime) and individual intervention adherence.
- The intervention was implemented hospital-wide in the Johns Hopkins Hospital Medical ICU (MICU).
Main Results:
- The QI framework facilitated the development and implementation of a multifaceted sleep promotion project.
- Performance measures tracked adherence to sleep-promoting interventions.
- While long-term adherence and sustainability present challenges, the model demonstrated a structured approach to sleep improvement.
Conclusions:
- The described QI framework offers a robust foundation for future initiatives aimed at promoting sleep in ICU settings.
- Sustained staff engagement and regular project evaluation are critical for the long-term success of sleep promotion efforts.
- This systematic approach can guide other ICUs in addressing sleep disturbances among critically ill patients.
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