From Evidence to Clinical Practice : Staff Empowerment for Caring of People Admitted in Psychiatric Intensive Care Units(PICU) with Sleep Problem

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Abstract Description
Abstract ID :
HAC1893
Submission Type
Authors (including presenting author) :
Kwok CMY(1), Po KML (2), Lau, LW (1), Ngan HY (1), Lam K (1), FU YY (1), Luk, KY (1), Ma, CF (1), Poon KH (1)
Affiliation :
(1) Kwai Chung Hospital
Introduction :
Insomnia is the most prevalent and prominent presenting symptoms in the context of a wide range of psychiatric disorders. 346 patients in Psychiatric Intensive Care Units(PICU). 236 (64.7%) of patients reported to have poor quality sleep. 153 (43.9%) of patients being prescribed with sleeping pills. The Centre for Health Protection (2018) highlights that most insomnia can be effectively treated and prevented from recurrence by paying attention to good “sleep hygiene”. The psychiatric nurses of Kwai Chung Hospital were gearing to the direction of a person-centred service based on effective treatment and the recovery of the individuals. This project is grounded on the available evidences to address the modifiable factors/risk factors of sleep problem (Morin, 2013), and attempts to deliver an integrated package of interventions to scaling up care.
Objectives :
to engage and to empower psychiatric nurses to implement evidence based practice (EBP) and to improve patient outcomes.
Methodology :
Methodology: An EBP nursing workgroup (inpatient) was formed in 2018. The team members went through the EBP process: 1) identified the service needs, 2) formulated relevant questions, 3) conducted search and critical appraisal, 4) translated the evidence to clinical practice guidelines, 5) provided staff empowerment activities on EBP concept, theory/ evidence of sleep promotion, and daily clinical decision making 6) facilitated the implementation of sleep promotion program. The program was implemented in 2 PICUs in phase one, and 2 PICUs were allocated as comparators randomly in October 2019. The outcome measures were categorized on i) the knowledge of staff in EBP and sleep interventions, iii) patients’ outcomes and satisfaction.
Result & Outcome :
36 psychiatric nurses from 2 implementation PICUs, and 42 psychiatric nurses from 2 comparator PICUs are participated. A Mann-Whitney test indicated that the EBP knowledge scores were higher for nurses working in implementation units (Mdn=5) than nurses who are working comparator units (Mdn=3) (U= 74.5, p=0.00) ; the sleep knowledge scores were higher for nurses working in implementation units (Mdn=13) than nurses who are working comparator ward (Mdn=7 ) (U= 5.5, p=0.00) . 32 patients from 2 implementation PICUs, and 25 patient from 2 comparator PICUs are recruited. The sleep knowledge of patients in the Implementation PICUs was also higher (Mdn=3) than the comparators wards (Mdn=1) (U=80, p=0.00). The preliminary findings indicated the nursing competence was improved and patients were very satisfied with the program.

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