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Effect of noise on hospitalized patient
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Recommended: Effect of noise on hospitalized patient
The understanding and utilization of outcome measures is a requisite skill for today’s healthcare leader. According to Dlugacz (2006), “The successful health care professional is committed to running an efficient organization, and that entails understanding data from quality indicators and measures and how these data can be used to link clinical results and policy information” (pg2).
Sleep in the modern day, technologically advanced Intensive Care unit (ICU) is fragmented and poor. ICUs are not designed to promote sleep, but rather to alert and engage staff in patient safety. Sleep deprivation and fragmentation impairs neurocognitive function and healing (Friese, 2008). This neurocognitive disruption is often referred to in the ICU environment as delirium.
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Imagine how outcomes might improve if we allowed patients to sleep.
My MindMap explores the processes and outcomes obtained through the implementation of an ICU sleep protocol. Instituting the sleep protocol in an ICU with various admitting physicians and patient diagnosis will allow the data to be analyzed objectively and in aggregate (Dlugacz, 2006). I believe that the implementation of a sleep protocol will enable patients to sleep in the ICU. The Inputs for this study will include the development of a sleep protocol, education to ICU staff regarding alarm management, the ability to measure sleep through the use of polysomnography and finally the use of a noise monitor to alert staff when the unit is becoming too noisy. The desired outputs from this intervention include a decrease in ICU delirium, Increased patient satisfaction, and decreased ICU length of stay which will lead to an increased financial strength. These are ambitious outcome objectives. The only way to truly know if the implementation of a sleep protocol makes a difference in patient outcomes is through data analysis and measurements. These measurements need to include both qualitative and
In order to make the decision, this report measures the following qualitative and quantitative areas:
Fontana, C. J. (2010). Sleep Deprivation Among Critical Care Patients. Critical Care Nursing Quarterly , 75-81.
Featherstone, P., Prytherch, D., Schmidt, P., Smith, G. (2010). ViEWS: towards a national early warning score for detecting adult inpatient deterioration. Resuscitation, 81(8), 932-937.
Hospitalized patients are often hooked up to monitoring devices such as heart monitors, which monitor the electric activity of the heart, or connected to a physiological monitor so their vital signs are constantly being measured. These monitors are intended to continuously assess the patients’ status, and alarm if the patients’ status drops below what is considered normal. The increased use of monitoring devices has created a new phenomenon known as alarm fatigue. According to the ECRI institute (2011), “alarm fatigue occurs when the sheer number of alarms overwhelms staff and they become desensitized to the alarms resulting in delayed alarm response and missed alarms-often resulting in patient harm or even death.” Alarm fatigue has become a major problem within the nursing community and has already had a negative impact on patient safety. Due to the adverse effects alarm fatigue is having on quality patient care, there has been a call to action to find solutions that may deter alarm fatigue. Evidence-based practices involving quality improvement initiatives have been put into effect. The problem has also gained national attention from such institutions as the Food and Drug Administration (FDA) and The Joint Commission (TJC).
This article has shown me that new strategies are needed to reduce sleep disturbances, improve sleep quality, and support the need for supplemental daytime sleep in hospitalized individuals. These strategies include monitoring patients’ sleep and assess quality of sleep and duration, resolving the problems of sleep disturbance, recognizing that nighttime noise, light, and other factors potentially interfere with patient sleep, minimize lighting in shared patient rooms and turn off lights earlier at night, frequently assess for pain and administer prescribed pain medications to minimize sleep disruption. This article taught me more about sleep cycles and disturbances in hospitalized patients. As a future nurse, I have to accurately assess the patients’ personal characteristics and health education needs, and share this knowledge with my classmates.
Despite interventions aimed at decreasing noise, sound levels continue to exceed WHO recommendations and the ICU sounds (e.g., alarms and conversations) may interfere with sleep. The psychological impact of noise in the ICU varies. For some patients, the sounds in the ICU are comforting and for others they cause distress. To create a therapeutic environment, continued efforts are needed to decrease background noise, and to modify behaviors and factors that cause peak noise events. Interventions to protect patients from noise in the ICU, such as earplugs, may be beneficial in optimizing outcomes; however, further research is needed in a broader ICU population. Finally, to evaluate the effects of these interventions, valid and reliable methods for outcomes, such as sleep and sound levels, must be used.
...ep. There are events in sleep that are associated with synaptic modification, which is the basis of brain rewiring that enhances cognition. There is evidence that sleep accelerated transcription of cortical genes that are associated with protein synthesis9. These newly generated proteins are known to be required for strengthening of existing synapses and building new synapses. Studies have found increase of factors associated with brain-plasticity and enhanced learning during sleep5. These factors include phosphorylated or activated CREB, a transcriptional factor, as well as Arc, BDNF, and NGFI-A. These evidence help explain how sleep can influence brain rewiring through synaptic modification. This mechanism helps explain how sleep can modify the brain and ultimately enhance learning. This is a strong evidence that supports the synaptic downscaling hypothesis.
One of the pivotal roles of a nurse is the ability to recognise patient deterioration. The skill of identifying crucial elements of deterioration and acting appropriately is fundamental for positive patient outcome. A vital skill performed primarily by nurses is the act of respiratory rate measurement. This skill is performed in addition to five other physiological parameters, which form a basis for a scoring system. The scoring systems commonly used are known as NEWS (National Early Warning Score) and EWS (Early Warning Score). As many adverse events are preceded by a period of time where by the patient exhibits physiological dysfunction, there is often time to correct abnormalities. This has significance for nurses, as they are responsible
Prevention of ICU psychosis should occur as soon as the patient has been in the ICU for a few hours. Review visiting policies for the facilities, provide great periods of sleep, by reducing the disturbing and noise levels in the patient room, also try to minimize shift change in nursing staff caring for the patient, assess the patient alertness for the place, date and time on every shift(Welker, M. MSN, 2016). ICU psychosis can be increase by health care professional awareness of early clinical signs of delirium during patients assessment(Arend, E., Christensen, M. 2009). ICU psychosis is affecting the majority of the patient admitted to the ICU. Evidence base shows that the ICU environment is contributed to it’s development. Delirium is increased with morbidity and mortality as well as increased with length of stay in the intensive care unit(Arend, E., Christensen,
It’s hard to leave a loved one in a hospital bed when night falls. Family members leave with a sense of responsibility, guilt, and sadness. They leave relying on the nurse to watch and care for their sick family member. Therefore, it is heart breaking to find out the next morning your loved one has suffered great brain damage due to nurses failing to check on alarm sounds. Now, the family is put on the spot to continue life support or disconnect their family member. One can only imagine what went wrong; up to the minute that you left the hospital, your loved one was doing fine. You are relying on the health care providers to take care of your loved one, just as you would, while you are gone. Staff made an error by ignoring the alarms sounds, warning them that the patient was deteriorating, and costing the patient’s family a great deal of pain. Jenifer Garcia’s life shattered when this exact event happened to her husband in July, 2010 (Kowalczyk, 2011). She left her husband Friday night, alive, and returned the next morning to find out he was brain dead. Advancements in technology are used to decrease and catch medical errors made by health care providers that can harm or kill patients, but alarm fatigue has proven that even technology cannot fully protect a patient from nursing errors, thus taking the lives of patients.
Delirium is a sudden, fluctuating, and usually reversible disturbance of mental function (Fan, Guo, Li, & Zhu, 2012). Delirium has been identified in several hospital settings, however occurs more frequently in an Intensive Care setting. Risk factors are not limited to a certain age, race, or gender. There are several long and short term adverse effects associated with Delirium, and may even leave the patient in a decreased mental state after discharge. It is important to use the proper assessment tools to identify delirium in patients. More so, it is imperative that the medical and nursing staff be aware of all risk factors, signs and symptoms, and interventions to minimize and properly treat delirium in the ICU setting.
: Much is said about how long shifts and nurse-to-patient ratio affect the nurse’s health, but little attention has been paid about the effects of sleep deprivation on the health and care of nursing professionals. Although it is important to understand the effects of long hours of work, researchers should also look attentively on the effects of insufficient sleep on the life of nurses.
Snoring is a common disorder that affects millions of people around the world. Even though normal snoring is not dangerous to human health, having repeated breathing stops during the snoring process can be life threatening to the snorer. According to the American Heart Association (2012) study, having repeated breathing stops during the snoring process is dangerous and can result in the development of cardiovascular problems and even death. This condition is known as sleep apnea. In this respect, an individual with sleep apnea experiences repeated breathing stops for as many as thirty times an hour when asleep. Such episodes are dangerous for the snorer since it increases the risk of developing heart failure, high blood pressure, stroke, and arrhythmias. Research shows that one in every five people suffers from sleep apnea. America, in particular, has one of the highest incidences of people with this disease. According to Lettieri (2010), about 15 million adults suffer from obstructive sleep apnea in America. The majority of people with sleep apnea are patients with cardiovascular problems and hypertension. As earlier mentioned, this condition is life threatening and require early treatment. This document will examine the historical evidence of the disease, its causes, and its clinical effects on the cardiovascular system, complications, and prognosis. The discourse will also explore the treatments and research associated with the disease.
There are still many barriers interfering with sleep in the hospital, as the disruption of sleep is common through frequent monitoring and procedures, noise, lighting, and anxiety about being in the hospital (Robinson et al., 2005). Another barrier is the critical care environment, which has more invasive monitoring and tests and noise from monitors and ventilators (Eliassen & Hopstock, 2011).
In a pre-hospital setting, there are few moments that are as intense as the events that take place when trying to save a life. Family presence during these resuscitation efforts has become an important and controversial issue in health care settings. Family presence during cardiopulmonary resuscitation (CPR) is a relatively new issue in healthcare. Before the advent of modern medicine, family members were often present at the deathbed of their loved ones. A dying person’s last moments were most often controlled by his or her family in the home rather than by medical personnel (Trueman, History of Medicine). Today, families are demanding permission to witness resuscitation events. Members of the emergency medical services are split on this issue, noting benefits but also potentially negative consequences to family presence during resuscitation efforts.