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Simple measures to promote sleep can reduce delirium in intensive care patients
Date:2/20/2013

A hospital is not the best place to get a good night's sleep, especially in a noisy intensive care unit. It's a cause for concern because studies have shown that a lack of sleep can cause patients to experience deliriuman altered mental state that may delay their recovery and lead to short and long-term confusion and memory problems.

A team of doctors, nurses, psychologists and pharmacists in the medical intensive care unit (MICU) at The Johns Hopkins Hospital implemented a project to see if by taking simple steps to reduce nighttime noise, light,and staff interruptions, as well as stopping certain medications for insomnia, they could reduce delirium and improve patient perceptions about the quality of their sleep. Their findings are described in an article posted online by Critical Care Medicine that will be printed in the journal's March issue.

"With our interventions, we were able to improve a patient's odds of being free of delirium in the ICU by 54 percent, even after taking into account the diagnosis, need for mechanical ventilation, age and other factors," says Biren Kamdar, M.D., M.B.A, M.H.S., a Johns Hopkins pulmonary and critical care fellow who led the initiative. "In addition, many patients said that the ICU was quiet and comfortable enough for them to get a good night's sleep," he says.

Three sets of interventions were introduced in stages. The first was a 10-item environmental checklist that included turning off televisions, room and hallway lights, safely consolidating the number of staff visits to patient rooms overnight for drawing blood and giving medications to reduce interruptions, reducing overhead pages and minimizing unnecessary equipment alarms.

In the second stage, patients also were offered eye masks, ear plugs and tranquil music. In the final stage, a new medication guideline was introduced that discouraged giving patients certain commonly prescribed drugs for sleep, such as benzodiazepi
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Contact: Ellen Beth Levitt
eblevitt@jhmi.edu
410-955-5307
Johns Hopkins Medicine
Source:Eurekalert

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