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In The ICU (set to auto-advance slide) (Lt. Click to Self Advance)

Sleep Information For Patients. In The ICU (set to auto-advance slide) (Lt. Click to Self Advance). Sleep Cycle. Active sleep- REM (rapid eye movement ) sleep. Quiet Sleep- NREM ( Non-REM sleep) NREM sleep has 4 stages. Stage 4 NREM sleep = deepest sleep.

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In The ICU (set to auto-advance slide) (Lt. Click to Self Advance)

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  1. Sleep Information For Patients In The ICU (set to auto-advance slide) (Lt. Click to Self Advance)

  2. Sleep Cycle • Active sleep- REM (rapid eye movement ) sleep. • Quiet Sleep- NREM ( Non-REM sleep) • NREM sleep has 4 stages. • Stage 4 NREM sleep = deepest sleep. • Hormones released to promote healing and growth during stage 4 NREM sleep.

  3. Human Sleep Cycle • Normal sleep = 4 to 6 sleep cycles. • Each cycle is approx 120-180 min. • Stage 4 NREM sleep is the last 15-30 min.

  4. Sleep Deprivation • Acute or chronic lack of sufficient, quality, restorative sleep. • Being deprived of sleep due to experimental, or real life conditions.

  5. Signs and SymptomsPhysical • Elevated Blood Pressure • Increased Heart Rate • Increased Inflammation • Increased Risk of Cardiovascular Event • Increase Risk of Diabetes • Immunosuppression • Inhibition of Wound Healing • Increased Level of Stress

  6. Deprivation of Sleep“…sleep deprivation can affect the healing process and thus contribute to an increased morbidity and mortality.” -SL Krachman, GE D'Alonzo and GJ Criner Chest, Vol 107, 1713-1720, 1995

  7. 0-48 hrs Restlessness Irritability Verbal Abuse Disorientation By 96 hrs Psychotic Behavior Physical Abuse Signs and SymptomsBehavioral

  8. Contributing Factors to Sleep Deprivation in the ICU Patient Factors Non-Patient Factors

  9. Patient Related Factors • Age • Gender • Acuity of Illness / Condition • Personality • Motivation

  10. Non-Patient Factors Environment: Lighting, Temperature, Proximity to Noise Frequency of Interruptions: Monitoring, Testing ( CAT scans, X-rays, Labs) Professional Assessments / Interventions Anxiety / Fear Discomfort / Pain Medication Side Effects

  11. Your Nurse Will • Promote Patient Comfort • Promote Pain Control • Promote Sleep/ Consistent Sleep Patterns • Promote Patient Psychological Well-Being • Promote Environment Conducive to Sleep

  12. Promoting ComfortThe Nurse Will • Position patient to maximize comfort • Provide clean, dry, wrinkle-free linens, extra blankets, and pillows • Bathe patient daily, provide massage.

  13. Promote Pain ControlThe Nurse Will • Administer sedatives, analgesics, paralytics per orders, communicate contraindications. • Analgesics should be administered 30 min. prior to sleep. • Monitor for adverse reactions. • Monitor and report efficacy.

  14. Promote Sleep The Nurse Will • Establish / Limit / Enforce visiting hours. • Coordinate ancillary testing so as to minimize sleep interruptions. • Coordinate medical staff interventions to maximize sleep time. • Establish sleep schedule to follow circadian rhythm, facilitating hormone balance. Patient has sleep time at night, awake time during the day, as is possible.

  15. Provide Psychological Well-Being The Nurse Will • Reduce anxiety and stress by reassuring the patient. • Explain thoroughly procedures, tests, potential outcomes, options. • As is possible, promote patient participation in their treatment, care …. • Listen.

  16. Provide Environment For Sleep • Minimize noise levels from nursing stations, monitors, visitors, phones, hallway traffic, other patients. • Lower lighting levels. • Keep temperatures moderate. Avoid extremes. • Minimize visual stimulation.

  17. Patient Outcomes • Patient will get adequate ( stage 4NREM ) sleep as evidenced by: • Decreased anxiety and stress. • Healing well. • Elimination / reduction in restlessness, irritability, physical / verbal abuse, psychotic episodes. • Stable vitals. • Decreased inflammation. • Absence of infection.

  18. The End“and to all - goodnight!”

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