The Effect of Nocturnal Patient Care
Interventions on Patient Sleep and Satisfaction
With Nursing Care in Neurosurgery
Intensive Care Unit
Gu ¨ lay Altun Ug ˘ras $, Sultan Babayigit, Keziban Tosun, Gu ¨ ler Aksoy, Yu ¨ ksel Turan
ABSTRACT
Background: Sleep disturbance in an intensive care unit is a common problem. One of the main factors
causing sleep disturbances in an intensive care unit is nocturnal patient care interventions. Aims and
objectives: This study aims to determine the impact of patient care interventions performed at night in
a neurosurgical intensive care unit on patients’ sleep and their nursing care satisfaction. Methods: The
descriptive study was conducted on 82 patients in a neurosurgical intensive care unit between January
2009 and March 2010. The data were collected by data collection instruments and Newcastle Satisfaction
with Nursing Scales. The data were statistically analyzed by frequency, mean, standard deviation,
chi-square, and MannYWhitney U test. Results: The study showed that 53.7% of the patients experienced
sleep disturbances in the neurosurgical intensive care unit. Because of nursing interventions at night,
39.1% of these patients had their sleep affected, but this problem did not cause any negative impact on
the patients’ satisfaction (Newcastle Satisfaction with Nursing Scales score = 88.21 T 9.83). The patients
received, on average, 42.21 T 7.45 times patient care interventions at night; however, the frequency
of patient care interventions at night showed no effect on sleep disturbances in this study (p 9 .05). The
most frequently given patient care interventions were, respectively, vital signs monitoring, neurological
assessment, and repositioning in bed. These interventions were performed commonly at 6 A.M., 12 A.M.,
and 7 P .M. Conclusion: In this study, despite the patients reporting sleep disturbances in the neurosurgical
intensive care unit because of nocturnal patient care interventions that prevented them from sleeping, the
patients’ satisfaction on the given nursing care was not negatively impacted. To reduce sleep disturbances
because of nursing care initiatives and promote uninterrupted sleep in the intensive care unit, it can be
useful to develop new protocols regulating night care activities.
Keywords: intensive care unit, nocturnal patient care interventions, nursing care satisfaction, sleep
disturbances
S
leep is essential to generate the energy to recovery
from illness (DeKeyser, 2003; Dennis, Lee,
Woodard, Szalaj, & Walker, 2010; Fontana &
Pittiglio, 2010). During sleep, protein synthesis and
cell division are organized and result in a restorative
process (Dennis et al., 2010). Sleep disturbance in in-
tensive care units (ICUs) is a common and known
problem (Bourne & Mills, 2004; DeKeyser, 2003;
Fontana & Pittiglio, 2010). ICU patients may have
difficulty in falling asleep; experience diminished rapid
eye movement sleep and changes in their circadian
rhythms; wake up more often than normal or be
awakened because of noise, anxiety, pain, frequent
treatments, and nursing care interventions and mon-
itoring activities (Boyko, Krding, & Jennum, 2012;
Cmiel, Karr, Gasser, Oliphant, & Neveau, 2004;
DeKeyser, 2003). The negative effects of lack of
sleep on ICU patients’ bodies can start to be observed
within as little as 24Y48 hours. The rise in stress level
increases the serum cortisol level. This causes a reduction
Journal of Neuroscience Nursing 104
Questions or comments about this article may be directed to Gu ¨ lay
Altun Ug ˘ras $, PhD RN, at carpediem0803@yahoo.com. She is an
Assistant Professor, Health School of Surgical Nursing Department,
Mersin University, Mersin, Turkey.
Sultan Babayigit, RN, is a Registered Nurse, Istanbul Cerrahpas $a
Medical Faculty, Neurosurgery Intensive Care Unit, Istanbul University,
Istanbul, Turkey.
Keziban Tosun, RN, is Head Nurse, Cerrahpas $a Medical Faculty,
Neurosurgery Department, Istanbul University, Istanbul, Turkey.
Gu ¨ ler Aksoy, PhD, is Professor, Nursing High School, Department of
Surgical Nursing, Halic University, Istanbul, Turkey.
Yu ¨ ksel Turan, RN, is a Registered Nurse, Istanbul Cerrahpas $a Medical
Faculty, Neurosurgery Intensive Care Unit, Istanbul University, Istanbul,
Turkey.
The work was performed at the Intensive Care Unit, Department of
Neurosurgery, Istanbul University Cerrahpas $a School of Medicine.
The authors declare no conflicts of interest.
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Copyright B 2015 American Association of Neuroscience Nurses
DOI: 10.1097/JNN.0000000000000122
Copyright © 2015 American Association of Neuroscience Nurses. Unauthorized reproduction of this article is prohibited.