Authors (including presenting author) :
Kwok CMY(1), Po KWL(1), Lau KW(1), Poon, KH(1), FU YY(1), Lam K (1), Ngan HY (1), Luk KY (1), Ma CF (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. Over 60% of in-patient reported to have poor quality of sleep. Patients with psychiatric diagnoses, sleep disturbances are associated with the increased risk of relapse and suicidal behaviors. Good quality and restorative sleep is essential for day-to-day functioning, and preserving regular circadian rhythms has been found to lower the risk of sleep disorders, mental health disorders and chronic health problem (The World Sleep Day 2018). 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 identified the service needs and enhanced clinical attention and intervention on sleep disturbances for person admitted in PICUs
Objectives :
To strengthen the evidence based practice to improve the patient care
To empower patients with sleep problem and to handle the complexity of illness management proactively
Methodology :
The evidence based workgroup (in-patient) had been keeping up knowledge of evidence based practice (EBP) , summarize evidences and recommendation. They prepare clinical practice guideline and materials for advanced practice, e.g. educational materials for staff and patients, i.e. identification of potential causes of insomnia, circadian rhythm, light and melatonin suppression, wake/sleep at neurotransmitter level and intervention bundles etc. 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 :
1. Clinical practice guideline for Promotion of Sleep in PICU Care Pathway and intervention bundles was prepared. It is helpful to translate evidence into actionable recommendations that can be applied to clinical situations, and assist nurses and patient decisions about appropriate health care for specific circumstances systematically. 2. The score for knowledge of EBP and sleep promotion were higher in nursing staff in implementation wards (Mdn=18) than the comparator units (Mdn=10) (U= 2, p=0.00). 3.The score for sleep knowledge of 32 patients in the implementation PICUs was also higher (Mdn=3) than the 25 patients from comparator PICUs (Mdn=1) ( (U=80, p=0.00) and most patients were very satisfied with the program.
