Pflege
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The objective of this article is to present a literature review of German and English literature concerning sleep disturbances of critically ill adults in intensive care units. It represents mainly nursing research-based studies which focused on characteristics and possible causes of sleep disturbances. The literature revealed that patients suffer from moderate to severe sleep deprivation characterized by a decrease of total sleep length and quality, and by sleep fragmentation. ⋯ Nurses have an important role to play in recognizing and assessing factors that contribute to sleep deprivation and in intervening to reduce the effects of sleep deprivation. The research studies in this review represent the positivistic scientific perspective where sleep deprivation research has been objectified and controlled. A broader, more indepth understanding is needed, however, so that the subjective view of critically ill persons can be represented.
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The aim of this interdisciplinary project was the improvement of postoperative pain management on surgery wards of an university hospital: Pain medication should be enlarged with the possibility to administer an opium-medication i.v. (non only s.c.) when needed (VAS > 3), which has been tested on two wards. The study shows the resulting changes of the intervention for patients and nurses. For recording, there has been patient questionnaires and document analysis before and after the new possibility to administer medication, and a nurses opinion survey. ⋯ The enlargement to administer pain medication and asking/registering pain intensity regularly, created more sensitivity for the patient's pain-experience among nurses, and this lead to better use of the prescribed pain medication and to better pain management overall. Further quality-improvement in post-operative pain relief seems possible by continuing on that way in the future.