Monitoring of night-time nursing interventions in Spanish paediatric critical care units

Abstract

Introduction: The hostile environment in paediatric intensive care units (PICU) favours sleep-wake biorhythm dysregulation. Sleep disorders have detrimental impact on the immune, neurological and cardiovascular systems, in addition to increasing morbidity and mortality rates. Sleep plays a crucial role in brain development, rendering paediatric patients particularly vulnerable to the adverse effects of sleep disorders due to their ongoing neurological growth. The factors that affect rest include, among others, noise, lighting, treatment, and nocturnal nursing interventions, although the evidence for the latter is still scarce. Objective: To identify the nocturnal nursing interventions, following the NIC taxonomy, carried out in PICU. Method: A multicentre, cross-sectional, descriptive study was performed using an ad hoc survey to identify nocturnal nursing interventions in the PICU. The collected variables were characteristics of the participating PICU and those derived from the nursing interventions. During the analysis, mean and standard deviation of quantitative variables, and frequency tables and percentages were generated for qualitative variables. The variables were operationalized and Student's t-test and ANOVA were calculated for comparison between variables. Results: One hundred records were obtained, encompassing 5017 interventions, with the most repeated intervention being ¿vital signs monitoring¿. The mean number of different interventions identified was 23 ± 7.66 and the mean frequency of these was 50.17 ± 19.28. There were significant differences between the hospital variable and the number and frequency of interventions performed (p < 0.001). Discussion: We agreed with other studies in identifying ¿vital signs monitoring¿ as the most frequent intervention. ¿Improving sleep¿ was one of the most frequently reported, in contrast to other studies where interventions related to rest were not documented. Conclusions: The most frequently performed interventions in the PICU were identified. In most of the registers some intervention on improving rest was identified, which could indicate the latent concern of the health care professionals for the sleep of the critical child.