title: Quiet time for mechanically ventilated patients in the medical intensive care unit.
abstract: OBJECTIVE
  Sleep disruption occurs frequently in critically ill patients. The primary aim of this study was to examine the effect of quiet time (QT) on patient sedation frequency, sedation and delirium scores; and to determine if consecutive QTs influenced physiologic measures (heart rate, mean arterial blood pressure and respiratory rate).
  
  
  METHODS
  A prospective study of a quiet time protocol was conducted with 72 adult patients on mechanical ventilation.
  
  
  METHODS
  A Medical Intensive Care Unit (MICU) in the Midwest region of the United States.
  
  
  RESULTS
  Sedation was given less frequently after QT (p=0.045). Those who were agitated prior to QT were more likely to be at goal sedation after QT (p<0.001). Although not statistically significant, the majority of patients who were negative on the Confusion Assessment Method (CAM-ICU) prior to QT remained delirium free after QT. Repeated measures analysis of variance (ANOVA) for three consecutive QTs showed a significant difference for respiratory rate (p=0.035).
  
  
  CONCLUSIONS
  QT may influence sedation administration and promote patient rest. Future studies are required to further understand the influence of QT on mechanically ventilated patients in the intensive care unit.
authors.affiliation: Medical Intensive Care Unit, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States. Electronic address: mcandre3@uwm.edu.
authors.forename: Natalie S
authors.initials: NS
authors.lastname: McAndrew
authors.affiliation: Medical Intensive Care Unit, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States.
authors.forename: Jane
authors.initials: J
authors.lastname: Leske
authors.affiliation: Marquette University, United States.
authors.forename: Jill
authors.initials: J
authors.lastname: Guttormson
authors.affiliation: University of Wisconsin-Milwaukee, United States.
authors.forename: Sheryl T
authors.initials: ST
authors.lastname: Kelber
authors.affiliation: Medical Intensive Care Unit, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States.
authors.forename: Kaylen
authors.initials: K
authors.lastname: Moore
authors.affiliation: Medical Intensive Care Unit, Froedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, United States.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Dabrowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000451:nursing; D003693:Delirium / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000523:psychology; D012892:Sleep Deprivation / Q000150:complications / Q000517:prevention & control*
keywords: Critical care; Delirium; Hospital noise; Quiet time; Sleep