Sleep Protocols Essay

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.

1. What is the nurse's highest priority for a patient experiencing sleep deprivation? What would we teach them about this? What treatment would be expected? Safety would be highest priority; sleep deprivation causes psychomotor deficits. Interventions that can help with sleep deprivation would be avoiding stimulating activities in the hours before bed. Avoid exercise, caffeine, and screen time just before bed. It’s also a good idea to avoid eating a large meal, as this can interfere with healthy sleep. Create a comfortable sleep environment. One medication that the patient can be prescribed on would be Zolpidem is a short-acting hypnotic that will help the patient initiate sleep and awaken without untoward symptoms of drowsiness. Also, Gamma-aminobutyric acid (GABA) and galanin are sleep-promoting neurotransmitters that can be used as a treatment.

Sleep is important not only for promoting healing, but also for the overall well-being of the individual. When there are problems with the sleeping pattern, it impacts the overall health and safety of the older adult. The person will not have enough rest and will be too tired to perform activities surrounding daily living. We have to assess the risk factors contributing to the problems of sleep disturbance and these might be “related to poor sleep hygiene, including an irregular sleep schedule, environmental noise or light, and the use of stimulants” (Mauk, 2014, p. 581). If the sleeping pattern is not assessed, possible complications will happen, such as falls that could lead to bodily injuries.

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.

Nurse’s sleep was evaluated using wrist-worn actigraph with the support of a sleep log; Karolinska Sleepiness Scale (KSS) and Occupational Fatigue Exhaustion Recovery scale (OFER) were used to evaluate fatigue levels baseline and intershift. Performance level was assessed using the Walter Reed Psychomotor Vigilance Test (PVT). Consecutive shifts where found to increase the levels of ongoing fatigue and sleepiness (sleep debt); with increasing performance issues (lapsing) on the PVT test on the second and third consecutive shifts worked. This research study includes a respectable data size (80 nurses) with respected and strong data collection tests (actigraph, KSS, OFER, and PVT). Limitations of the study include a short duration of data collection cycle, no measure of the effect of shift rotation preceding the shifts worked, and possible data variance due to nurses who could have worked multiple jobs.

With regard to sleepiness, several studies indicated that the average of sleep duration in 1910 to 2002 have decreased from 9 to 6 hours on workdays (National sleep foundation, 2002; Groger et al., 2004). Recently, a survey study of Roger et al. (2004) shows that an American Nurses have an average of 84 minutes more sleep on non workdays. Thus, shift work suggested as a cause of sleeping disorder among nurses where they feel of sleep during the shift. Considering the contributing factors of sleepiness, the literature identified that long working hours and rotating shifts are causing sleeping disorder. In the night and rotating shifts, the nurses are rarely obtained adequate amount of sleep. In fact, the nurses experiencing less sleeping hours (1 to 4 hour) than normal sleeping (Zeisler et al.,1980). Nevertheless, insufficient sleep is a significant reason of damaging planning, decision-making, and integration of information (Krueger, 1994; Harrison and Horne, 2000). More recent studies have revealed that long hour shifts and overtime are strongly linked to the difficulties of being a wake through the shift which leads to increase the risk of making an error (Scott et al., 2006; Roger et al., 2004).

The continued shortage of registered nurses will be a catalyst for the increasing stress placed upon practicing nurses now and in the future. Mandatory overtime has been an incessant problem within the nursing profession. When lives are at risk, alertness is a critical part of a nurse’s job performance. Fatigue impairs one’s judgement directly affecting patient and nursing safety or outcomes. This author’s typical six week work schedule consists of eighteen-twelve hour shifts, nine “required” twelve hour call shifts, and three-four hour back-up shifts. A nurse that accepts a patient assignment in the operating room cannot legally or ethically leave when their shift has ended without proper relief. Inevitably, without proper staffing departure is not an

The purpose of this qualitative study is to “provide an in-depth description of critical care nurses’ practices, preferences, and perceptions of napping/not napping when working night shift in either an emergency department or an intensive care unit (ICU)” (Fallis, McMillan, & Edwards, 2011, p. e3). The introduction states that many nurses must remain highly vigilant while providing 24-hour care to unstable patients. Night shifts continue to be a source of stress because sleep deprivation and fatigue increase risk for errors and personal injuries. Restorative napping can improve performance; however, this practice is often disapproved by management and frequently hindered by care responsibilities and insufficient

Can you imagine costing a patient their life due to your lack of sleep, long shifts, and working to many hours? Me either. “In 2011, the Joint Commission issued a Sentinel Event Alert to call attention to health care worker fatigue as it relates to patient safety, noting a link between healthcare worker fatigue and adverse events. In addition to patient safety concerns, there is an increased risk of injury in fatigued healthcare workers (Martin, 2015).” Lets explore the dangers of fatigue, and its importance to nurses, way that nurses can prevent fatigue, and possible ways to lower fatigue and enhance sleep. What standards are in place in the nurse practice

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,

A single-system research intervention was implemented with a 46-year-old Caucasian female as the subject. The participant is a single personal trainer who lives in Northern New Jersey. The subject has recently dealt with various life changes, such as the death of a family member and the sudden illness of another. She has reported having great difficulty falling asleep due to feeling “anxious” and her “mind racing” throughout the evening hours. The subject reports that it takes well over an hour for her to fall asleep on any given night. Due to her health conscious daily living practices, she is uninterested in utilizing any form of medication to assist her in falling asleep. Additionally, due to the subjects busy lifestyle and early morning work hours, she expressed great interest in attempting to determine a method that would assist in regulating her sleep schedule, as currently, it is negatively impacting various areas of her life.

Purpose: To inform the audience about what sleep is and how it helps the body.

The term ‘Shift work’ is usually referred to uniformly divided allocations of the day in which individuals participate alternatively to provide twenty four hour coverage. A shift in sleep schedule conflicts with the body’s natural clock also known as the circadian rhythm into interpreting the time as ‘inappropriate’ and disrupts the homeostatic regulation cycle resulting in poor health outcomes. Fortunately, it is deemed possible to counter unfavourable effects of alternating insomnia and sleepiness through certain practices.

The components of sleep hygiene guidelines include exercise recommendations, cognitive behavior therapy, progressive muscle relaxation (guided imagery and abdominal breathing),sleep restriction and stimulus control.(L.De La Rue-Evans et al.,2012).These components address each of the domains in the theoretical model: cognitive impairments(deficits in memory, concentration and executive functioning),physical symptoms(fatigue,insomnia,headaches,tinnitus),emotions and behaviors(depression,fear,anger),functional status(IADLS-finances,work,leisure activities) and interpersonal interactions(support, relationship ,communication).(Daggett et al.,2013)Each of the concepts are related to each other and also related to the characteristics of the individual (patient demographics)and characteristics of the environment(adjusting to the society, returning to work).(Daggett et al.,2013).This explains how this model will guide in promoting a conducive sleep

The case here is about the aged care facility with the greater number of residents having irregular sleeping pattern and are awake during the night resulting in daytime sleepiness. Daytime sleepiness is causing lack of physical activity; disturbed eating pattern and the residents tend to sleep for a long period during the day. In this assignment I am going to do research about what could be the reason behind this issue with the help of evidence based information using different nursing literatures.