Night-time care routine interaction and sleep disruption in adult cardiac surgery.

Abstract

To explore the context and the influence of night-time care routine interactions (NCRIs) on night-time sleep effectiveness (NSE) and daytime sleepiness (DSS) of patients in the cardiac surgery critical-care and progressive-care units of a hospital. There exists a paucity of empirical data regarding the influence of NCRIs on sleep and associated outcomes in hospitalised adult cardiac surgery patients. An exploratory repeated-measures research design was employed on the data provided by 38 elective cardiac surgery patients (mean age 60.0±15.9years). NCRI forms were completed by the bedside nurses and patients completed a 9-item Visual Analogue Sleep Scale (100-mm horizontal lines measuring NSE and DSS variables). All data were collected during postoperative nights/days (PON/POD) 1 through 5 and analysed with IBM SPSS software. Patient assessment, medication administration and laboratory/diagnostic procedures were the top three NCRIs reported between midnight and 6:00 a.m. During PON/POD 1 through 5, the respective mean NSE and DSS scores ranged from 52.9±17.2 to 57.8±13.5 and from 27.0±22.6 to 45.6±16.5. Repeated-measures ANOVA showed significant changes in DSS scores (p<.05). NSE and DSS were negatively correlated (r=-.44, p<.05), but changes in NSE scores were not significant (p>.05). Finally, of 8 NCRIs, only 1 (postoperative exercises) was significantly related to sleep variables (r>.40, p<.05). Frequent NCRIs are a common occurrence in cardiac surgery units of a hospital. Further research is needed to make a definitive conclusion about the impact of NCRIs on sleep/sleep disruptions and daytime sleepiness in adult cardiac surgery. Worldwide, acute and critical-care nurses are well positioned to lead initiatives aimed at improving sleep and clinical outcomes in cardiac surgery.