Developing a Quality Improvement Project: Evaluating Nurses’ Knowledge, Perceptions, Attitudes, and Beliefs Regarding Sleep Promotion in the ICU

Abstract

"Objective: The purpose of this Doctoral of Nursing Practice (DNP) project was to conduct a survey to evaluate nurses’ knowledge, perceptions, attitudes, and beliefs regarding sleep promotion in the ICU. Background: Critically ill patients admitted into the Intensive Care Unit (ICU) are introduced into unfamiliar environments with numerous interruptions that interfere with proper sleep. Sleep deprivation among critically ill patients can have detrimental consequences for the patient and organization. Competing nursing priorities, lack of knowledge, opposing perceptions, and lack of resources prevent the implementation of strategies to promote patient sleep. Methods: This project used a descriptive design to conduct the assessment. A web-based survey was distributed to assess nurses’ knowledge, beliefs, attitudes and perceptions regarding sleep promotion in the ICU to help identify areas for improvement and barriers to implement an effective quality improvement plan. Setting: A 30-bed ICU at an academic medical center with 268 licensed beds in Phoenix, AZ with medical-surgical, cardiac, neurological, vascular, and transplant patient populations. Participants: Sample of 57 out of 175 critical care nurses who work in this project’s ICU setting. Findings: ICU nurses demonstrated concern for lack of sleep among critically ill patients, but it is difficult to promote due to competing priorities and tasks. Nurses overall understood the negative effects of sleep disruption among critically ill patients, but discussed the importance of maintaining staff accountability, working collaboratively with the interdisciplinary team, promoting consistency in care, and obtaining support and resources from administration to implement effective interventions. Implementation: Identified barriers and gaps should be utilized to direct quality improvement efforts that help promote uninterrupted sleep among critically ill patients."