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Monitoring of night-time nursing interventions in Spanish paediatric critical care units
Alicia Gomez-Merino1, Patricia Luna-Castaño2, Marta Martín-Velasco3
1Programa de Doctorado en Ciencias Biomédicas y Salud Pública de la Universidad Nacional a Distancia (UNED), Spain; Unidad de Cuidados Intensivos Pediátricos, Hospital La Paz, Madrid, Spain; Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, Spain.
Insights
Nocturnal nursing interventions in Paediatric Intensive Care Units (PICUs) were identified, with vital signs monitoring being most frequent. Many interventions aimed at improving sleep, suggesting a growing concern for critical children's rest.
Area of Science:
- Pediatric Intensive Care
- Nursing Interventions
- Sleep Science
Background:
- Paediatric Intensive Care Units (PICUs) present a hostile environment that disrupts sleep-wake biorhythms.
- Sleep disorders negatively impact pediatric immune, neurological, and cardiovascular systems, increasing morbidity and mortality.
- Children are particularly vulnerable to sleep disorder effects due to ongoing brain development.
Purpose of the Study:
- To identify and categorize nocturnal nursing interventions utilized in Paediatric Intensive Care Units (PICUs).
- To follow the Nursing Interventions Classification (NIC) Taxonomy for intervention identification.
Main Methods:
- A multicenter, cross-sectional, descriptive study was conducted.
- An ad hoc survey was used to collect data on nocturnal nursing interventions in PICUs.
- Quantitative and qualitative variables were analyzed using descriptive statistics, Student's t-test, and ANOVA.
Main Results:
- A total of 5017 interventions were recorded across 100 patient records.
- "Vital signs monitoring" was the most frequently performed intervention.
- Significant differences in the number and frequency of interventions were observed between hospitals (P < .001).
Conclusions:
- "Vital signs monitoring" is confirmed as the most common intervention in PICUs.
- Interventions aimed at "improving sleep" were frequently reported, contrasting with previous research.
- The frequent documentation of sleep-promoting interventions suggests a developing focus on critical children's rest among healthcare professionals.
Introduction:
The hostile environment in Paediatric Intensive Care Units (PICU) favours sleep-wake biorhythm dysregulation. Sleep disorders have detrimental impact on the immune, neurological and cardiovascular systems, in addition to increasing morbidity and mortality rates. Sleep plays a crucial role in brain development, rendering paediatric patients particularly vulnerable to the adverse effects of sleep disorders due to their ongoing neurological growth. The factors that affect rest include, among others, noise, lighting, treatment, and nocturnal nursing interventions, although the evidence for the latter is still scarce.
Objective:
To identify the nocturnal nursing interventions, following the NIC Taxonomy, carried out in PICUs.
Method:
A Multicentre, cross-sectional, descriptive study was performed using an ad hoc survey to identify nocturnal nursing interventions in the PICU. The collected variables were characteristics of the participating PICU and those derived from the nursing interventions. During the analysis, mean and standard deviation of quantitative variables, and frequency tables and percentages were generated for qualitative variables. The variables were operationalized and Student's t-test and ANOVA were calculated for comparison between variables.
Results:
100 records were obtained, encompassing 5017 interventions, with the most repeated intervention being "Vital signs monitoring". The mean number of different interventions identified was 23 ± 7.66 and the mean frequency of these was 50.17 ± 19.28. There were significant differences between the hospital variable and the number and frequency of interventions performed (P < .001).
Discussion:
We agreed with other studies in identifying "Vital signs monitoring" as the most frequent intervention. "Improving sleep" was one of the most frequently reported, in contrast to other studies where interventions related to rest were not documented.
Conclusions:
The most frequently performed interventions in the PICU were identified. In most of the registers some intervention on improving rest was identified, which could indicate the latent concern of the health care professionals for the sleep of the critical child.
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