• Julián Díaz-Alonso, Andrea M Smith-Plaza, Belén Suárez-Mier, and Alberto Lana.
• Julián Díaz-Alonso, RN, is a registered nurse specialized in critical care and with extensive formation in emergencies at the Intensive Care Unit, Asturias Central University Hospital, Oviedo, Spain. He is currently a PhD candidate at the University of Oviedo. Andrea M. Smith-Plaza, RN, is a registered nurse specialized in family and community health at the Preventive Medicine and Public Health Department, School of Medicine and Health Sciences, Oviedo, Spain. She is also junior researcher in the Department of Medicine at the University of Oviedo. Belén Suárez-Mier, RN, is a senior clinical researcher and a preventive medicine nurse at the Preventive Medicine Unit, Asturias Central University Hospital, Oviedo, Spain. Furthermore, she is a nursing assistant professor at the University of Oviedo. Alberto Lana, PhD, is senior researcher at the University of Oviedo. He has extensively published on several health related topics, including nursing practice.
• Dimens Crit Care Nurs. 2018 Nov 1; 37 (6): 310-317.

BackgroundPatients of adult intensive care units (ICUs) often suffer from a lack of sleep. Reducing anxiety by promoting adaptation to the ICU prior to admission may be an appropriate way to increase sleep quality.ObjectiveThe aim of this study was to evaluate the impact on sleep quality of a brief nurse intervention.MethodsThis was a pilot randomized controlled trial in Spain. Forty patients admitted in hospital for valve cardiac surgery were randomly allocated to (1) control group (n = 20), receiving usual care, and to (2) experimental group (EG, n = 20), receiving a nurse intervention the day before surgery and admission in the ICU. The intervention was based on Roy Adaptation Model. A trained nurse anticipated the stressful stimulus to patients in order to develop functional adaptive behaviors. A set of photographs and videos was used to illustrate the environment and assistance in the ICU. Sleep quality in the ICU was measured with the Richards-Campbell Sleep Questionnaire and usual sleep quality with the Pittsburgh Sleep Quality Index.ResultsAfter the intervention, sleep quality was lower in the EG compared with the control group (-4 points in Richards-Campbell Sleep Questionnaire, P = .69). Adjustment for main confounders led this reduction to -1.9 points (P = .87) among patients in EG. Stratified analyses shown a positive impact for people who usually slept well (+5.2 points, P = .77), but negative for those who had previous poor sleep quality (-20.0 points, P = .24).ConclusionA nurse intervention prior to ICU admission did not increase patients' sleep quality. In addition, the intervention could have incremented anxiety over the patients who used to sleep poorly at their homes.

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