運用睡眠組合式照護提升加護病房病人睡眠品質

Applying a Sleep Care Bundle to Improve Quality of Sleep in Patients in the Intensive Care Unit

背景：住院期間不良的睡眠品質，可能導致病人住院後症候群，而增加再住院率及死亡率。本加護病房病人理查茲—坎貝爾睡眠量表（Richards-Campbell Sleep Questionnaire, RCSQ）平均總分偏低，第三天平均總分49.7 mm，第五天平均總分51.7 mm，故成立專案改善。目的：考量病人病況及臨床醫療因素，設定第五天RCSQ之目標值由51.7 mm提升至76.0 mm。解決方案：專案小組提出具實證基礎的睡眠組合式照護，包括：非藥物輔助疼痛控制、環境調節方法、流程改善措施及個別性睡眠輔助照護措施。結果：病人在接受睡眠組合式照護後，第三天的RCSQ平均總分由49.7 mm提高到55.9 mm，而第五天的RCSQ平均總分由51.7 mm提高到80.9 mm。結論：運用睡眠組合式照護有效降低睡眠干擾因素，改善加護病房病人睡眠品質。

Background & Problems: Poor sleep quality during hospitalization may lead to post-hospital symptoms and increase readmission rates and mortality. Patients in our intensive care unit (ICU) reported low mean scores on the Richards-Campbell Sleep Questionnaire (RCSQ) during their third and fifth days of hospitalization (49.7 mm and 51.7 mm, respectively). Therefore, a project to improve sleep quality in the ICU was established. Purpose: To increase the mean RCSQ score from 51.7 mm to 76.0 mm on the fifth day. The fifth day timeframe was chosen because of the disease conditions of the patients and related clinical-medical factors. Resolution: The project team proposed an evidence-based, sleep care bundle that included non-medication pain control, environmental regulation, improvement of the care process, and individualized sleep care. Results: After implementing the bundled intervention, the mean RCSQ score of patients in our ICU increased from 49.7 mm to 55.9 mm on the third day and from 51.7 mm to 80.9 mm on the fifth day. Conclusion: This application of a sleep care bundle effectively improved the factors affecting sleep disturbance and improved quality of sleep in the patients in our intensive care unit.