VNJ Volume 39 (5) October 2024 | Page 27

Plus-Hex CLINICAL

However , there may be some occasions where the suggested change is ineffective and requires ongoing modification . High inpatient caseloads can be challenging and clustered treatment times can be busy and stressful . The author hopes that VNs may be able to reduce this stress by accepting that lowerpriority treatments or interventions may , on occasion , be delivered late . Role modelling this behaviour and creating a practice ethos of support are steps the author is taking to achieve this sense of empowerment .

Implementing the new practice-wide protocol has been time-consuming and requires ongoing training and monitoring . Treatments are often still scheduled outside the recommended times , which is attributed to a lack of awareness or forward thinking . This has disrupted patient rest and caused some concern to the nursing team . The author hopes that , over time , VNs working in the wards will feel empowered to move the treatments ( when suitable ) to the scheduled times .

Overall , it is pertinent to acknowledge that the changes described in this article are not a complete solution to the problem : patients do not receive adequate rest . In a referral setting , where patients require frequent treatments and monitoring to achieve nursing goals , the balance between patient interaction and patient rest is delicate . However , the modifications described in this article have certainly improved the quality of patient rest and have maximised VN efficiency and planning .

8 Oldham MA , Lee HB , Desan PH . Circadian rhythm disruption in the critically ill : an opportunity for improving outcomes . Critical Care Medicine . 2016 ; 44 ( 1 ): 207 – 217 . Available from : https :// doi . org / 10.1097 / CCM . 0000000000001282 .

9 Knauert MP , Haspel JA , Pisani MA . Sleep loss and circadian rhythm disruption in the intensive care unit . Clinics in Chest Medicine . 2015 ; 36 ( 3 ): 419 – 429 . Available from : https :// doi . org / 10.1016 / j . ccm . 2015.05.008 .

10 Delaney LJ , Currie MJ , Huang HCC , Lopez V , Van Haren F . “ They can rest at home ”: an observational study of patients ' quality of sleep in an Australian hospital . BMC Health Services Research . 2018 ; 18 : 524 . Available from : https :// doi . org / 10.1186 / s12913-018-3201-z .

11 Pisani MA , Friese RS , Gehlbach BK , et al . Sleep in the intensive care unit . American Journal of Respiratory and Critical Care Medicine . 2015 ; 191 ( 7 ): 731 – 738 . Available from : https :// doi . org / 10.1164 / rccm . 201411-2099CI .

12 Stiver K , Sharma N , Geller K , Smith S , Stephens J , Daoud E , et al . “ Quiet at night ”: reduced overnight vital sign monitoring linked to both safety and improvements in patients ' perception of hospital sleep quality . Patient Experience Journal . 2017 ; 4 ( 1 ): 90 – 96 . Available from : https :// doi . org / 10.35680 / 2372-0247.1185 .

13 Mason NR , Orlov NM , Anderson S , Byron M , Mozer C , Arora VM . Piloting I-SLEEP : a patient-centred education and empowerment intervention to improve patients ' in-hospital sleep . Pilot and Feasibility Studies . 2021 ; 7:161 . Available from : https :// doi . org / 10.1186 / s40814- 021-00895-z .

14 Johansson L , Knutsson S , Bergbom I , Lindahl B . Noise in the ICU patient room – staff knowledge and clinical improvements . Intensive and Critical Care Nursing . 2016 ; 35 : 1 – 9 . Available from : https :// doi . org / 10.1016 / j . iccn . 2016.02.005 .

15 Konkani A , Oakley B . Noise in hospital intensive care units — a critical review of a critical topic . Journal of Critical Care . 2012 ; 27 ( 5 ): 522 . e1 – 522 . e9 . Available from : https :// doi . org / 10.1016 / j . jcrc . 2011.09.003 .

REFERENCES

1 Vincent J-L , Shehabi Y , Walsh TS , Pandharipande PP , Ball JA , Spronk P , et al . Comfort and patient-centred care without excessive sedation : the eCASH concept . Intensive Care Medicine . 2016 ; 42 ( 6 ): 962 – 971 . Available from : https :// doi . org / 10.1007 / s00134-016-4297-4 .

2 Chahraoui K , Laurent A , Bioy A , Quenot J-P . Psychological experience of patients 3 months after a stay in the intensive care unit : a descriptive and qualitative study . Journal of Critical Care . 2015 ; 30 ( 3 ): 599 – 605 . Available from : https :// doi . org / 10.1016 / j . jcrc . 2015.02.016 .

3 Lefman SH , Prittie JE . Psychogenic stress in hospitalized veterinary patients : causation , implications and therapies . Journal of Veterinary Emergency and Critical Care . 2019 ; 29 ( 2 ): 107 – 120 . Available from : https :// doi . org / 10.1111 / vec . 12821 .

4 Papaioannou V , Mebazaa A , Plaud B , Legrand M . ‘ Chronomics ’ in ICU : circadian aspects of immune response and therapeutic perspectives in the critically ill . Intensive Care Medicine Experimental . 2014 ; 2 : 18 . Available from : https :// doi . org / 10.1186 / 2197-425X-2-18 .

5 Fullagar B , Boysen S , Toy M , et al . Sound pressure levels in 2 veterinary intensive care units . Journal of Veterinary Internal Medicine . 2015 ; 29 ( 4 ): 1013 – 1021 . Available from https :// doi . org / 10.1111 / jvim . 13574 .

6 Chudler E . How much do animals sleep ? Neuroscience for Kids . Available from : https :// faculty . washington . edu / chudler / chasleep . html [ Accessed 26 July 2024 ].

7 Tembo AC , Parker V . Factors that impact on sleep in intensive care patients . Intensive and Critical Care Nursing . 2009 ; 25 ( 6 ): 314 – 322 . Available from : https :// doi . org / 10.1016 / j . iccn . 2009.07.002 .

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Volume 39 ( 5 ) • October 2024

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