Nurses' perceptions of the layout and environment of the paediatric intensive care unit in terms of sleep promotion

Abstract

Background: Noise and light are frequently cited as major factors contributing to sleep disturbance. The paediatric intensive care unit (PICU) layout may increase environmental stimuli and limit nurses' control over the environmental disturbances that patients encounter.

Aim: This study aims to describe nurses' perceptions regarding the layout of the PICU and its potential impact on environmental disturbances and patients' sleep. Additionally, it seeks to investigate the extent to which unit layout impacts environmental disturbances across Scandinavian countries.

Study design: A comparative cross-sectional study was conducted using an online questionnaire in three PICUs in three large university hospitals in Norway, Sweden and Denmark.

Results: Out of the 79 study participants, 63% did not agree that their PICU layout was conducive to their patients sleeping well. While 52% reported having control over the light at nighttime, 55% felt that they were unable to control noise levels during the night. Monitors and alarms were rated as the highest contributing factors limiting control over noise. Compared to the Danish nurses, the Norwegian nurses were five times less likely to agree that the unit layout supported a normal sleep-wake cycle.

Conclusion: The Scandinavian nurses perceived the PICU layouts as inadequate for promoting control over the environment and patients' sleep. The Norwegian PICU layout, with larger multibed units, was perceived as inferior in promoting sleep and controlling noise and light compared with the Swedish and Danish PICUs.

Relevance to clinical practice: This study provides valuable insights to nurses regarding the specific factors influencing noise and light in the PICU, enabling nurses to take appropriate measures to improve sleep by gaining control over the patient's environment. Additionally, the results of this study can inform future renovations or modifications of multibed units, with the aim of preventing the layout from restricting nurses' control over the noise and light levels experienced by patients.

Keywords: PICU; critical care nursing; environment; intensive care units; paediatric; sleep.