Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Misty Evans, DNP, APRN, CPNP-AC
• Committee Member Name & Credentials:
  Marshay James, DNP, MSNEd, APRN, CPNP-AC, CPEN, CNE

DNP Project Abstract

Noise Reduction to Promote Sleep Hygiene in the Pediatric Intensive Care Unit

Purpose
This quality improvement (QI) initiative assessed the impact of a sleep hygeine bundle with scheduled quiet time on sleep quality and quantity among pediatric criitical care patients and caregivers in the Pediatric Intensive Care Unit (PICU).

Methods
A QI initiative conducted at an academic PICU. Five sound monitors were placed in patient rooms, hallways, and provider stations. A nurse-driven Quiet at Night bundle to reduce nighttime noise was implemented for 53 patients and 33 caregivers over a two-month period.

Results
Patients with scheduled quiet time experienced an increase in quantity of sleep (M = 4.96 hours, SD = 1.16) compared to patients without scheduled quiet time (M = 4.48 hours, SD = 1.61).  Caregivers experienced a decrease in quantity of sleep with scheduled quiet time (M= 4.36 hours, SD = 1.27) versus without (M= 4.61 hours, SD = 1.68).  There was also a decrease in the reported quality of sleep for caregivers and patients following scheduled quiet time.

Implications for Practice
Substantial need for sleep improvement still exists in the PICU and the utilization of a quiet at night bundle can increase the quantity of sleep in the patients in the PICU. The study reinforced that there are numerous factors leading to sleep disturbance in the PICU. The results showed a decrease in quality of sleep in the PICU for both patients and caregivers and the quantity of sleep for the caregivers after the intervention, which continues to indicate a need for sleep improvement in the PICU.