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Sleep quantity and quality of critically ill children perceived by caregivers and bedside nursing staff: a pilot
Micaela A Witte1, Robin M Lloyd2, Michaela McGree3
1Department of Internal Medicine and Pediatrics, University of Michigan, Ann Arbor, Michigan.
Insights
Caregivers perceive critically ill children's sleep in the pediatric intensive care unit (PICU) as lower quality than at home. However, caregivers and nursing staff largely agree on sleep quality, quantity, and environmental factors within the PICU.
Area of Science:
- Pediatric intensive care
- Sleep medicine
- Critical care nursing
Background:
- Sleep is vital for healing in critically ill children.
- Pediatric intensive care unit (PICU) environments often disrupt sleep.
- Caregiver and nursing staff perceptions of sleep-impairing factors are not well-compared.
Purpose of the Study:
- To compare caregiver and bedside nursing staff perceptions of sleep quality and environmental factors in PICU patients.
- To assess caregiver-reported changes in sleep quality and environmental factors from home to the PICU.
Main Methods:
- A pilot study surveyed caregivers and nursing staff of 31 pediatric patients in the PICU.
- Participants rated environmental factors (temperature, light, sound, room entries), sleep quality, and quantity.
- Caregivers also reported on their child's sleep at home.
Main Results:
- No significant differences were found between caregiver and nursing staff ratings for sleep quality, quantity, or most environmental factors.
- Nursing staff reported significantly more room entries than caregivers.
- Caregivers reported lower sleep quality and more frequent room entries in the PICU compared to home.
Conclusions:
- Caregivers perceive their child's sleep quality in the PICU as lower than at home.
- There is substantial agreement between caregivers and nursing staff regarding sleep and environmental factors in the PICU.
- This consensus supports further research and interventions to improve pediatric sleep in the PICU.
Study Objectives:
Sleep is crucial for healing but often impaired in the pediatric intensive care unit due to environmental disruptions. Caregivers and bedside nursing staff are often most aware of these factors and the impact on patient sleep, but studies have not yet compared their perceptions.
Methods:
Caregivers and bedside nursing staff of pediatric patients staying a second night in the pediatric intensive care unit were asked to complete a survey regarding environmental factors (ie, temperature, light, sound, nursing staff room entries), sleep quality, and sleep quantity (ie, sleep duration, number of naps) of the pediatric patient. Caregivers were asked similar questions about their child's sleep at home.
Results:
The caregivers and nursing staff of 31 pediatric patients participated in this pilot study. There was no significant difference between caregiver and nursing staff ratings of sleep quality, sleep duration, number of naps, room temperature, sound, or light (P > .05 for all). Nursing staff did report significantly more room entries than caregivers (P = .01). Compared to sleep at home, caregivers reported sleep in the hospital to be of lower quality (P = .009) with more frequent room entries (P = .01).
Conclusions:
Caregivers rate their child's sleep in the pediatric intensive care unit as lower quality than sleep at home. Caregivers and bedside nursing staff largely agree about pediatric patient sleep quality and quantity as well as environmental factors. This agreement may facilitate further research and interventions at improving sleep in the pediatric intensive care unit.
Citation:
Witte MA, Lloyd RM, McGree M, Kawai Y. Sleep quantity and quality of critically ill children perceived by caregivers and bedside nursing staff: a pilot study. J Clin Sleep Med. 2023;19(12):2027-2033.
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