Evidence-based sleep promotion in acute care from the perspective of nursing staff: a cross-sectional study

TL;DR

This study explores how nursing staff in hospitals understand and promote sleep for patients, finding that while they value sleep, they often don't use available resources to help patients sleep better.

Contribution

The study provides new insights into nursing staff's knowledge and implementation of evidence-based sleep promotion in acute care settings.

Findings

Nursing staff value sleep promotion but do not consistently use available tools and resources.

Only a minority of staff in intervention units were familiar with the web-based course or clinical guidelines.

Active implementation strategies are needed to successfully promote evidence-based sleep practices.

Abstract

When hospitalised, patients’ sleep affects their ability to cope with the physiological and psychological strains of illness, and poor sleep negatively affects their recovery. Nursing staff have an important role in promoting patients’ sleep, yet little is known about their knowledge and attitudes towards sleep promotion. The aim was to describe knowledge and values of evidence-based sleep promotion among nursing staff in acute care. A secondary aim was to assess the attention given to sleep promotion and the implementation of a sleep-promoting intervention.

A cross-sectional cohort study using web-based questionnaires distributed from April to May, 2024. The questionnaires were sent to nurses and nursing assistants at the intervention units (cardiovascular and neurology departments), where an intervention has been introduced. The intervention is designed to enhance the knowledge and competence regarding in-hospital sleep among nursing staff and comprises three parts; a web-based course, evidence-based clinical guidelines and sleep nursing champions who function as sleep advocates at their respective units. Questionnaires were also distributed to control units at the oncology department, where the intervention is yet to be implemented.

In total, 179 questionnaires were completed, 129/389 (33%) from the intervention units and 50/175 (29%) from the control units. Sleep was rated as highly important, and no statistical differences were seen between the groups regarding knowledge of or attention given to sleep promotion, nor the use of non-pharmacological methods to promote sleep. In the intervention group, only 53% were familiar with the web-based course and half of those had completed the course. The clinical guideline was known to 33% of the intervention group, and corresponding numbers regarding the sleep nursing champions were 36%.

Nursing staff are dedicated to sleep promotion and wish to increase their knowledge of non-pharmacological methods to promote sleep during hospitalization. However, the uptake of a sleep-promoting intervention in an acute care setting was limited and the staff did not utilize the available tools and resources. For successful dissemination of evidence-based sleep-promotion, active implementation strategies utilizing the engagement of patients, healthcare staff and policy makers are crucial.

Retrospectively registered at clinicaltrials.gov, registration number NCT07265713.

Figures