Sleep disruption is common among critically ill patients and is associated with adverse outcomes such as delirium, prolonged hospitalization, and impaired recovery. Although evidence supports non-pharmacological sleep hygiene interventions including noise reduction, dim lighting, clustered care, and sensory supports, consistent implementation of these practices remains challenging in intensive care settings. The purpose of this Doctor of Nursing Practice quality improvement project was to evaluate whether a structured educational intervention could improve nursing staff adherence to an evidence-based sleep hygiene bundle within a cardiac intensive care unit (CICU).This project was conducted in a 24-bed CICU at a large academic medical center and was guided by the Iowa Model of Evidence-Based Practice. A multi-modal educational intervention was implemented over an eight-week period and included staff education, visual reminders, supply accessibility improvements, and iterative Plan-Do-Study-Act cycles. Process outcomes were evaluated through four audit cycles measuring adherence to environmental and patient-facing bundle components. Staff knowledge and perceptions were assessed using pre- and post-intervention surveys.Environmental sleep hygiene practices demonstrated high adherence across audit cycles, with clustered care and alarm minimization reaching sustained implementation and lighting reduction remaining consistently high. Patient-facing interventions, including white noise machines, eye masks, and earplugs, demonstrated greater variability due to patient preference, equipment limitations, and inconsistent offering practices. Post-intervention survey responses indicated strong staff agreement regarding the importance of sleep promotion and increased confidence in implementing sleep hygiene strategies.These findings suggest that targeted staff education and reinforcement strategies can support integration of environmental sleep hygiene practices into routine nursing workflow in critical care settings.
Ikran Ali (Fri,) studied this question.