Dataset Information

Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night.

ABSTRACT:

Background

Intensive care unit (ICU) sleep disturbance is severe and potentially related to abnormal light and sound exposure.

Objectives

To assess the prevalence of measures of light and sound disturbance in ICU patient rooms, and whether these could be modified by a sleep-promotion intervention.

Methods

This observational study with a before and after design for a quality improvement initiative surveyed environmental factors in ICU rooms at 01:00 08:00, and 12:00. Surveys assessed light usage, television usage, window shade position, and room door/curtain position. Factors were compared before and after an ICU sleep-promotion intervention.

Results

990 (pre-intervention) and 819 (post-intervention) occupied rooms were surveyed. Pre-intervention, the prevalence of night-time factors included: bright lights on (21%), television on (46%), and room door open (94%). Post-intervention, more rooms had all lights off at night (41% v 50%, p = 0.04), and fewer rooms had open door curtains (57% v 42%, p = 0.001) and window shades (78% v 62%, p = 0.002).

Conclusions

Disruptive environmental factors are common in the ICU. Some factors improve with sleep-promotion interventions.

SUBMITTER: Altman MT

PROVIDER: S-EPMC6234066 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night.

Altman Marcus T MT Pulaski Catherine C Mburu Francis F Pisani Margaret A MA Knauert Melissa P MP

Heart & lung : the journal of critical care 20180822 6

<h4>Background</h4>Intensive care unit (ICU) sleep disturbance is severe and potentially related to abnormal light and sound exposure.<h4>Objectives</h4>To assess the prevalence of measures of light and sound disturbance in ICU patient rooms, and whether these could be modified by a sleep-promotion intervention.<h4>Methods</h4>This observational study with a before and after design for a quality improvement initiative surveyed environmental factors in ICU rooms at 01:00 08:00, and 12:00. Surveys ...[more]

PMID: 30143362

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Project description:BackgroundPoor working postures in morning care operations contribute significantly to work-related muscle fatigue and low back pain among ICU (Intensive Care Unit, ICU) nurses. However,there are few field studies on the relationship between Poor working postures and work-related muscle fatigue, low back pain among ICU nurses.ObjectiveThis study aims to assess the frequency and degree of posture hazards associated with poor working postures during morning care operations of ICU nurses.MethodsTwo ICUs in a Grade-A tertiary hospital in Hunan Province were randomly selected for the field study in May-June 2021 research. The image data of the participating nurses' morning care work postures were collected by observation method and image recording method, and the postural hazard level was assessed by the two-person interpretation method of the work posture analysis system. The mean and standard deviation, frequency and percentage were used for the basic statistical description, and the general linear model multivariate Hotelling's T2 test was used to calculate the Hotelling's T2 and F statistics to explore the pattern of change in the postural hazard score curves.ResultsA total of 45 nurses were observed during morning care operations, resulting in 47.8 h of video data and 34,428 effective static operation posture pictures. Among these pictures, 21,166 (61.5%) depicted poor working postures. Nurses spent up to 7 min and 30 s maintaining a challenging posture during oral care, with the highest postural hazard score (M = 2.2, SD = 0.3) observed during defecation care. Each patient requires a total of 25-30 min of oral care per day.The Hotelling's T2 test indicated that the change curve of the postural hazard score in each step revealed the largest second-order F value, F = 52.931, P < 0.001.DiscussionICU nurses frequently adopt poor working postures during morning care operations. Further research should focus on optimizing safe working postures to prevent or minimise detrimental occupational hazards resulting from poor working postures.Research on occupational low back pain among ICU nurses can help them work more efficiently, and thereby improving their nursing level.

Project description:Critically ill intensive care unit (ICU) patients commonly develop severe muscle wasting and impaired muscle function, leading to delayed recovery, with subsequent increased morbidity and financial costs, and decrease quality of life of survivors. Acute Quadriplegic Myopathy (AQM) is one of the most common neuromuscular disorders associated with ICU-acquired muscle weakness. Although there are no available treatments for the ICU-acquired muscle weakness, it has been demonstrated that early mobilization can improve its prognosis and functional outcomes. This study aims at improving our understanding of the effects of passive mechanical loading on skeletal muscle structure and function by using a unique experimental rat ICU model allowing analyses of the temporal sequence of changes in mechanically ventilated and pharmacologically paralyzed animals at durations varying from 6 h to 14 days. Results show that passive mechanical loading alleviated the muscle wasting and the loss of force-generation associated with the ICU intervention, resulting in a doubling of the functional capacity of the loaded vs. unloaded muscles after a 2-week ICU intervention. We demonstrated that the improved maintenance of muscle structure and function is likely a consequence of a reduced oxidative stress, and a reduced loss of the molecular motor protein myosin. A complex temporal gene expression pattern, delineated by microarray analysis, was observed with loading-induced changes in transcript levels of sarcomeric proteins, muscle developmental processes, stress response, ECM/cell adhesion proteins and metabolism. Thus, the results from this study show that passive mechanical loading alleviates the severe negative consequences on muscle structure and function associated with mechanical silencing in ICU patients, strongly supporting early and intense physical therapy in immobilized ICU patients. This study aims to unravel the effects of passive mechanical loading on skeletal muscle structure and function in an experimental rat ICU model at duration varying between 6h and 14 days. A total of 23 experimental female Sprague-Dawley rats were included in this study. The experimental rats were anaesthetized, treated with the neuromuscular blocking agent (NMBA) M-NM-1-cobrotoxin, mechanically ventilated and monitored for durations varying from 6h to 4 days (n=13), from 5 to 8 days (n=4), and from 9 to 14 days (n=6). The left leg of the animal was activated for 6 hours at the shortest duration and 12 hours per day at durations 12 hours and longer throughout the experiment, using a mechanical lever arm that produced a continuous passive maximal ankle joint flexions-extensions at a speed of 13.3 cycles per minute. Muscle biopsies were obtained from gastrocnemius muscle (proximal part) immediately after euthanasia, were quickly frozen in liquid propane cooled by liquid nitrogen, and stored at -80M-BM-0C. RNA was extracted.

Dataset Information

Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night.

Background

Objectives

Methods

Results

Conclusions

Publications

Non-circadian signals in the intensive care unit: Point prevalence morning, noon and night.

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