Benefits of quiet time interventions in the intensive care unit: a literature review
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Benefits of quiet time interventions in the intensive care unit: a literature review

Rimen Lim Clinical nurse specialist, Adult Intensive Care Unit, Prince of Wales Hospital, Randwick, Sydney, Australia

Sleep disturbance is a significant issue for patients in intensive care units (ICUs), which can affect their health and recovery from illness. Therefore, it is important to consider ways to address sleep disturbance in these settings. One strategy that has been suggested is the use of ‘quiet time’ interventions, which involve a defined period where there is a reduction in controllable light and sound, and where interruptions at the patient’s bedside are minimised.

Aim To determine the effectiveness of quiet time interventions in improving patients’ sleep quality in ICUs; to investigate other potential clinical benefits of quiet time interventions; and to consider the effect of incorporating open visitation when implementing quiet time interventions.

Method The author conducted a literature review of qualitative and quantitative studies that investigated the effects of quiet time interventions as a primary intervention in adult ICUs, with sleep quality as the outcome. Three databases were searched electronically for articles that met the inclusion criteria, and narrative synthesis was used to identify themes from these articles.

Findings A total of seven articles were included in this literature review. Overall, the evidence indicated that quiet time interventions can be effective in improving patients’ sleep quality; however, the study findings were variable and inconsistent. Quiet time interventions also appeared to provide some physiological benefits for patients, as demonstrated by reductions in respiratory rates, the administration of sedatives and the incidence of delirium, suggesting that patients are experiencing restfulness. Additionally, nurses reported an increasingly satisfying workplace environment following quiet time interventions.

Conclusion Quiet time interventions can improve patients’ sleep quality and have positive physiological effects for patients, such as improved restfulness. Quiet time interventions may also promote a healthier workplace environment and increase patient and family satisfaction. Considering the potential benefits and lack of evidence of harm, the author recommends that quiet time interventions are implemented in ICUs as part of routine practice.

Nursing Standard. 32, 30,41-48. doi: 10.7748/ns.2018.e10873

Correspondence

rimenlim@gmail.com

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Conflict of interest

None declared

Received: 28 March 2017

Accepted: 05 December 2017