title: Health care worker attitudes and identified barriers to patient sleep in the medical intensive care unit.
abstract: OBJECTIVE
  To identify barriers to sleep for intensive care unit (ICU) patients.
  
  
  METHODS
  A qualitative study using semi-structured interviews.
  
  
  METHODS
  Nurses and physicians who had experience working the night shift.
  
  
  METHODS
  None.
  
  
  RESULTS
  Multiple environmental barriers to sleep in the ICU were identified when participants were directly asked about factors affecting sleep. Responses highlighted healthcare system-based barriers related to hospital/ICU policy and workflow. Implicit barriers to sleep were found when participants responded to open-ended questions. These included attitudinal barriers such as the uncertainty about the significance of sleep, the tension between providing protocol-driven ICU care and allowing uninterrupted patient sleep, and lack of consensus regarding interventions to promote sleep.
  
  
  CONCLUSIONS
  This qualitative study suggests that health care worker attitudes, methods of sleep promotion, hospital institutional policies and workflow may contribute to sleep disruption in the ICU. These barriers provide additional targets for intervention in studies designed to improve sleep in the ICU.
authors: Portage Health Inc., 500 Campus Drive, Hancock, MI, USA.
authors: Katriina
authors: K
authors: Hopper
authors: Department of Internal Medicine, Geriatrics Section, Program on Aging, Yale University School of Medicine, USA.
authors: Terri R
authors: TR
authors: Fried
authors: Department of Internal Medicine, Pulmonary & Critical Care Section, Program on Aging, Yale University School of Medicine, USA. Electronic address: Margaret.Pisani@yale.edu.
authors: Margaret A
authors: MA
authors: Pisani
mesh_terms: D001291:Attitude of Health Personnel; D003422:Critical Care; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D009726:Nurses / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D012890:Sleep / Q000502:physiology*
keywords: Attitude of health personnel; Critical care; Health care providers; Intensive care unit; Qualitative research; Sleep