title: The development of a clinical practice guideline to improve sleep in intensive care patients: a solution focused approach.
abstract: OBJECTIVE
  Our objective was to develop a guideline to improve the opportunity for intensive care patients to rest and sleep.
  
  
  METHODS
  A pragmatic solution focused approach to guideline development and implementation was used in which data from international literature and original research from the study ICU were appraised in extensive consultation with intensive care staff. Audits were conducted early in the implementation phase to measure adoption rates.
  
  
  RESULTS
  Over 320 suggestions were made for inclusion in a practice guideline. Information was integrated to create the guideline. A comprehensive 'rest and sleep for the intensive care patient' guideline was developed comprising two main themes: 'Optimise the environment' (for example, 'Quiet conversation') and 'Rest and sleep interventions' (for example, 'Provide optimal conditions for night-time sleep'). Audit data suggested that adoption of the guideline had begun but was not yet embedded in practice.
  
  
  CONCLUSIONS
  The solution focused approach to addressing improvements ICU patients' sleep and the consideration of multiple sources of evidence resulted in the development of a comprehensive, context specific guideline. The process, based on a solution focus, may overcome difficulties faced by clinicians endeavouring to improve health care when there is a lack of high level evidence.
authors.affiliation: Faculty of Health, University of Technology, Sydney, Australia. Electronic address: Rosalind.Elliott@uts.edu.au.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Elliott
authors.affiliation: Faculty of Health, University of Technology, Sydney, Australia; Intensive care unit, Royal North Shore Hospital, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: McKinley
mesh_terms: D001315:Australia; D064648:Critical Care Nursing / Q000379:methods* / Q000592:standards*; D004779:Environment Design / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D017410:Practice Guidelines as Topic; D012890:Sleep
keywords: Critical illness; Implementation; Intensive care; Practice guidelines; Sleep