Sleep In The Hospitalized Patient : The American Association Of Critical-Care Nursing Research

As a provider of care, professional nurses depend on research, theories, and evidence based practice to guide the care they provide to patients. Nurses deliver care to their patients based on information they have learned through many years of school and training. Training for nurses and other providers of care is founded on theories, research, and evidence based practice in the healthcare field. Theories, research, and evidence based practice are all important for providing care to patients and each can be used in a different manner depending on the situation. Clinicians often use research based evidence to design and implement care that is high-quality and cost effective for patients. Evidence based practice can be used to provide care to patients in a steadily changing clinical environment. (PDF page 8-9). Nursing theories are frequently used as frameworks for establishing nursing care interventions and assessing

Sleep is often over looked as an intervention for ME, but through the improvement of environment, medication, life style changes and self-help strategies, sleep can be improved to help provide symptom relief and increase an individuals energy envelope. (ANZMES, n.d.c; Pemberton & Berry, 2009; Wright,

Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.

Christensen, M., Dodds, A., Sauer, J., & Watts, N. (2014). Alarm setting for the critically ill patient: A descriptive pilot survey of nurses' perceptions of current practice in an Australian Regional Critical Care Unit. Intensive & Critical Care Nursing, 30(4), 204-210. doi:10.1016/j.iccn.2014.02.003.

The evidence hierarchy is a ranking that distinguish the types of research evidence based on the strength of the evidence itself (Polit & Beck, 2012). It is mostly applicable to the research questions regarding the effects of clinical interventions. The evidence that are ranked based on the evidence that uses appropriate research methods, rigorously reviewed with minimized biases and has great clinical implications. The strongest evidence based on the evidence hierarchy is systematic reviews, which draws conclusions from many randomized controlled trails (Polit & Beck, 2012).

In the article “Sleepless in Stepdown” written by Joanne Matukaitis, MSN, RN, FABC, NE-BC; Thea Eckman, MSN, RN, CCRN; Kristan Baxter, BSN, CCRN-CSC; Elisabeth Bradley, MS, RN, APN; Helen Hawrylack, BSN, CCRN; Sharmila Johnson, MSN, RN, APN, CCRN; Ruth Mooney, PhD, MN, RN-BC; Donna Papanicolas, RN, and Patricia Brigss, MSN, RN, CCRN, HTP, discuss issues of possible sleep disturbances in the recovery process in the hospital. Their theory basically says that sleep disturbances may lead to extended stays in the hospital, but also how the patient recovers in the process. The authors’ also address the fact that physiologic, behavioral, and functional outcomes may also be influenced by sleep disturbance.

The title of this study “Sleep Quality in Nurses: A Randomized Clinical Trial of Day and Night Shift Workers” appropriately portrays the information of the article. It describes the design of the study, a randomized trial, as well as the topic, sleep quality of nurses. Overall it gives a good picture of what the article includes.

The authors recommend that the findings originating from this study can be used as a basis to initiate protocols for implementation of bedside nursing

“Sleeping while on duty” or “sleeping on the job” are terms that describe a worker falling asleep while working at an occupation (Fallis, McMillan, & Edwards, 2011). In the United States certain higher risk jobs involving security, safety, or health of others (such as nursing), the penalty for being caught sleeping on the job can range from disciplinary action to immediate termination of employment (Fallis, McMillan, & Edwards, 2011).

The effects of long work hours, resulting in insufficient sleep have been well documented (Rogers, 2008). Insufficient sleep alone has been noted to cause cognitive problems, mood alterations, reduced job performance, reduced motivation, increased safety risks, and physiological changes (Rogers, 2008). Failure to obtain a sufficient amount of sleep is even an important contributor to medical errors (Rogers, 2008). Now think of the effects of sleep, and add in stressful work environments, short-staffing, pressure from administration, and unexpected events, we can begin to realize how patient outcomes may be greatly compromised.

Level V is described as a “systematic review of descriptive and qualitative studies” (Melnyk site). According to Vincensi, Pearce, Redding, Brandonisio, Tzou, and Meiusi (2016), an exploratory cross-sectional survey design was performed to determine how both patients and nurses perceived sleep disruptions. I was unable to raise the ranking up to the next level due to the small sample size, the number of qualitative studies incorporated in the research review, and cross-sectional studies being considered one of the most biased. The other studies used for research purposes in this study included one randomized controlled trial (RCT), one quasi-experimental study, one qualitative study, and three literature reviews. The Vital Sleep Headband is described in depth in the article but the sample of nurses and patients only received surveys, videos, illustrations, and questionnaires about the validity of their use but no one actually used the headband which also contributed to the lower ranking. The sampling method used in this study was a convenience sampling, a nonprobability sampling strategy, considered the easiest and most commonly used

The work of Snethen et al. (2006) will be evaluated as level III for strength of evidence according to the practice guideline of the John Hopkins Nursing EBP (JHNEBP). This is because this article is a systematic review of case control studies with interpreted and translated findings of other studies. Given that the study has level III evidence, with definitive conclusion, sufficient sample size, adequate control, consistent recommendation for further study based on reviewed studies, the article is graded A for quality rating .

The quantitative research design and approach was necessary for this study because the researchers were interested in understanding cause and effect of implementing a spontaneous awakening and breathing protocol. They were also interested in making predictions about the quality impact of these interventions. The advantages of applying this design to this study included the assistance to offer causality, objectivity, generality, and statistical significance (Polit & Beck, 2017). These features were the measures the researchers needed for this study to determine if the protocol led to quality outcomes for the patients. The disadvantages of applying this design to this

The level of evidence of this article is level one in accordance with the John Hopkins Nursing Evidence-Based Practice Evidence Rating Scale (n.d.). Level one is given due to the utilization of RCTs and the evidence strength. Additionally, in

Some of the limitations associated with the study were as followed: unable to randomize participants into the control and treatment groups, data collection ended two months after operation, and the dissimilarity between polysomnography and subjective data (Greve & Pedersen, 2016). Some of the strengths were as followed: the education material was taught to the nurses by the principal author and subjective feeling of sleep quality improved (Greve & Pedersen, 2016).