The effect of rest and non-rest periods on physiological stability, sedation and agitation in ventilated patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/163144
Category:
Abstract
Type:
Presentation
Title:
The effect of rest and non-rest periods on physiological stability, sedation and agitation in ventilated patients
Author(s):
Mellott, Karen G.; Grap, Mary Jo; Hamilton, Ann; Best, Al; Wetzel, Paul; Munro, Cindy; Sessler, Curtis
Author Details:
Karen G. Mellott, MS, RN, Virginia Commonwealth University, Richmond, Virginia, USA, email: mellottkg@vcu.edu; Mary Jo Grap, PhD, ACNP, FAAN; Ann Hamilton, MS, RN, FNP; Al Best, PhD; Paul Wetzel, PhD; Cindy Munro PhD, ANP, FAAN; Curtis Sessler MD, FCCP, FCCM
Abstract:
Purpose: This study examines mechanically ventilated patients' biobehavioral responses during rest and non-rest periods in a Medical Respiratory ICU. Theoretical Framework: Rest periods may promote a healing environment through reduction of noise, light, and noxious stimuli which may improve physiological stability, reduce agitation and sedation. Methods (Design, Sample, Setting, Measures, Analysis): Twenty-four mechanically ventilated patients (71% female, Mean age= 53, Mean APACHE II score= 28) were studied. Time-synchronized, continuous 24-hour measurements of heart rate (HR), respiratory rate (RR), saturation of oxygen (SpO2), arm and leg movement (agitation), processed EEG (sedation = Patient State Index- PSI), and environmental light and sound were obtained for 435 h (mean 18.2 h/subject). Defined rest periods (2-4p, 1-3a) and non-rest periods (9-11a, 6-8p) were compared using ANOVA. Results: HR (p< 0.0001) and SpO2 (p< 0.0001) were higher during rest, while RR and leg movement (p< 0.0001) were higher during non-rest periods (p< 0.0001). No difference in arm movement was found. PSI was lower (more sedated) during rest (p< 0.0001). Light and sound levels were lower during rest than during non-rest periods. SpO2 levels were highest during the 2-4p rest period than during all other periods (p< 0.0001). RR was significantly increased during 9-11a, than during all other periods (p< 0.0001). Leg movement was significantly higher during 2-4p, than during all other periods (p< 0.0001). Sound levels were lowest during the 6-8p time, being different than all other time periods (p< 0.0001). Conclusions and Implications: Although sound was lower during rest periods, all levels were greater than recommended hospital standards, for both day and night. Rest periods may not be effective in promoting physiologic stability. Future research should investigate this, as well as causative variables and interventions to improve noise levels.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2007
Conference Name:
19th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
Providence, Rhode Island, USA
Description:
Conference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleThe effect of rest and non-rest periods on physiological stability, sedation and agitation in ventilated patientsen_GB
dc.contributor.authorMellott, Karen G.en_US
dc.contributor.authorGrap, Mary Joen_US
dc.contributor.authorHamilton, Annen_US
dc.contributor.authorBest, Alen_US
dc.contributor.authorWetzel, Paulen_US
dc.contributor.authorMunro, Cindyen_US
dc.contributor.authorSessler, Curtisen_US
dc.author.detailsKaren G. Mellott, MS, RN, Virginia Commonwealth University, Richmond, Virginia, USA, email: mellottkg@vcu.edu; Mary Jo Grap, PhD, ACNP, FAAN; Ann Hamilton, MS, RN, FNP; Al Best, PhD; Paul Wetzel, PhD; Cindy Munro PhD, ANP, FAAN; Curtis Sessler MD, FCCP, FCCMen_US
dc.identifier.urihttp://hdl.handle.net/10755/163144-
dc.description.abstractPurpose: This study examines mechanically ventilated patients' biobehavioral responses during rest and non-rest periods in a Medical Respiratory ICU. Theoretical Framework: Rest periods may promote a healing environment through reduction of noise, light, and noxious stimuli which may improve physiological stability, reduce agitation and sedation. Methods (Design, Sample, Setting, Measures, Analysis): Twenty-four mechanically ventilated patients (71% female, Mean age= 53, Mean APACHE II score= 28) were studied. Time-synchronized, continuous 24-hour measurements of heart rate (HR), respiratory rate (RR), saturation of oxygen (SpO2), arm and leg movement (agitation), processed EEG (sedation = Patient State Index- PSI), and environmental light and sound were obtained for 435 h (mean 18.2 h/subject). Defined rest periods (2-4p, 1-3a) and non-rest periods (9-11a, 6-8p) were compared using ANOVA. Results: HR (p< 0.0001) and SpO2 (p< 0.0001) were higher during rest, while RR and leg movement (p< 0.0001) were higher during non-rest periods (p< 0.0001). No difference in arm movement was found. PSI was lower (more sedated) during rest (p< 0.0001). Light and sound levels were lower during rest than during non-rest periods. SpO2 levels were highest during the 2-4p rest period than during all other periods (p< 0.0001). RR was significantly increased during 9-11a, than during all other periods (p< 0.0001). Leg movement was significantly higher during 2-4p, than during all other periods (p< 0.0001). Sound levels were lowest during the 6-8p time, being different than all other time periods (p< 0.0001). Conclusions and Implications: Although sound was lower during rest periods, all levels were greater than recommended hospital standards, for both day and night. Rest periods may not be effective in promoting physiologic stability. Future research should investigate this, as well as causative variables and interventions to improve noise levels.en_GB
dc.date.available2011-10-27T11:02:07Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:02:07Z-
dc.conference.date2007en_US
dc.conference.name19th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationProvidence, Rhode Island, USAen_US
dc.descriptionConference theme: Building Communities of Scholarship and Research, held April 12-14, 2007 at The Westin Providence.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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