article · International Journal of Drug Delivery Technology
Background Sleep deprivation and delirium are prevalent, severe complications among critically ill patients in the Intensive Care Unit (ICU), directly impairing recovery. This study evaluates the impact of implementing a nurse-led nocturnal quiet bundle designed to optimize sleep quality and prevent delirium. Aim To evaluate the effect of implementation of a nurse-led intensive care unit nocturnal quiet bundle to optimize sleep quality and prevent delirium among critically ill patients. Methods A quasi-experimental (pre-test/post-test) study was conducted in the Intensive Care Unit at Sohag University Hospital. Using a convenience sampling method, included 80 adult ICU patients (age ≥18 years, ICU stay ≥24–48 hours) who were awake, alert, and able to communicate were divided into preintervention (usual care) and post-intervention (quiet bundle). Patients with pre-existing cognitive/psychiatric disorders, severe hearing loss, primary neurological conditions, or continuous deep sedation (RASS -4/-5) were excluded. The nurse-led bundle was enforced nightly (10:00 PM– 6:00 AM), focusing on dimming lights, minimizing alarm volumes, and clustering care. Sleep quality was evaluated via the Richards-Campbell Sleep Questionnaire (RCSQ), and delirium was monitored using the Confusion Assessment Method for the ICU (CAM-ICU). Results Following bundle implementation, patient sleep quality scores improved significantly. The incidence of delirium and the total number of delirium days dropped sharply. Objective sound monitoring showed a noticeable decrease in decibel (dB) levels during the night shift, accompanied by high nursing staff adherence to the protocol. Conclusion A nurse-led nocturnal quiet bundle is an effective, safe, and low-cost intervention. It successfully alters the ICU environment to support physical and cognitive recovery, proving that non-pharmacological nursing strategies are vital in preventing critical care complications.
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DOI: 10.25258/ijddt.16.60s.31
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