Impact of reduce the sleep disruption causes at post-operative ICU among patients after open Heart

Abstract

Back ground Patients in ICU are experienced poor sleep quality and consistently report poor perceived sleep quality in ICU compared to home. Sleep disruption was the second most stressful condition reported by patients after open-heart surgery in ICU. Causes of sleep disruption at ICU are admission to ICU, separation from patients family, isolation, and fear of death, noise, light, extreme temperature , and diagnostic procedures, the patient being connected with many tubes, connection with machines, alarm of machines and monitors, and health team conversation. Existing evidence supports that ICU sleep promotion via multi-faceted interventions focused on minimization of nighttime sleep disruptions and maintenance of the homeostatic sleep-wake cycle. Therefore, the purpose of this study is reducing the causes of sleep disruption in ICU to improve patients sleep quality, and reduce complications. Patient and Method Quiz Experimental research design was used to conduct this research .This study was carried out at post-operative ICU in Assiut University Hospitals .The sample of this study was consisted of 40 patients, admitted to ICU after open-heart surgery. Tools used in this study are, First Tool: Patient's profile assessment sheet. Second Tool:1- sleep quality assessment questionnaire.2- Sleep disruption scale after open-heart surgery as a non-physiological assessment. Results: patients after open-heart surgery in ICU report poor sleep quality (1.5 ± 0.6) compared to home (9.9 ± 0.3).There is a significance increase (P<0.001) regarding to the overall quality of sleep in ICU stay for both groups. Highly significant decrease in overall degree of daytime sleepiness during ICU stay (p=0.000). Highly significant decrease in pulse rate of the study group (83.3 ± 10.7) versus control group (109.1 ± 14.8) through ICU says. Highly significant decrease in respiratory rate in 2nd day in ICU and poor significant differences in last day. Regarding to Systolic blood pressure there is statistical significant differences (p=0.003) in the2nd day. Regarding to length of ICU stay, there were highly significant decreased in study group versus control group (3.1 ± 0.3& 4.8 ± 1.1) day. Conclusion applying standard interventions to reduce sleep disruption causes in ICU was more effective to reduce complications of sleep disruption after open-heart surgery in study group versus control group who received routine hospital care. Recommendations: Patient preparation and provision of information should start from time of the surgeon's decision that surgery is required.