Nurses' autonomy in sleep management improves patients' sleep quality: A cross‐sectional study.

Background: The current literature indicates that intensive care (ICU) patients' sleep quality is generally poor, which is associated with serious physical and psychological consequences. Aims and objectives: To describe the practices nurses use to provide good‐quality sleep to adult ICU patients and assess nurses' perceptions of patients' sleep quality and nurses' professional autonomy in sleep management. Design: A descriptive‐correlational, cross‐sectional study. Methods: A total of 232 ICU nurses from four hospitals in Poland were recruited. Data were collected between May and August 2019 using a previously developed questionnaire and analysed using descriptive statistics and non‐parametric tests. Results: A total of 119 nurses took part in the study (response rate: 51%). On average, nurses rated patients' sleep quality as moderate (4.44 ± 2.23, scale 0‐10). Most of the respondents (95.8%) said they did not use any sleep protocol. Various strategies to improve patients' sleep were used sporadically (2.64 ± 1.55, scale 1‐5). The use of sleep quality assessment methods was positively correlated with patients' sleep quality (rho = 0.22, P =.02). Nurses' professional autonomy regarding sleep management was assessed as average (4.34 ± 2.43, scale 0‐10) and was correlated with the patients' sleep quality (rho = 0.25, P <.01). Nurses who rated their autonomy in patients' sleep management more highly (rho = 0.29, P <.01) and more often influenced patients' sleep decisions (rho = 0.24, P <.01) used more methods to improve patients' sleep. Conclusions: Strengthening the professional autonomy of ICU nurses and creating a reliable sleep assessment and improvement tool, which would describe strategies nurses can implement independently could increase sleep quality among ICU patients. Relevance to clinical practice: Addressing organizational problems, which hamper the patients' sleep management by ICU nurses could result in using more strategies to provide good‐quality sleep to ICU patients. There is a need for clinical guidelines regarding patients' sleep management to help educate and guide nurses how to independently use sleep improvement methods. [ABSTRACT FROM AUTHOR]