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The purpose of this study is to determine if the daily performance of a 7 step bedtime nursing protocol for hospitalized people living with dementia is feasible and if it has an effect on bedtime and daytime variables.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| daily sleep enhancement nursing protocol | Experimental | A 7 step nursing protocol. Each step is daily provided to the demented patient through a nurse by bedtime. Step 1: serve a late snack Step 2: evening care (brush teeth, get pyjama on, go to toilette) Step 3: note and treat physical circumstances that restrain sleep (pain, obstipation,...) Step 4: ensure comfortable position abed Step 5: assist to eliminate stressful situation (calm, reorientating conversation) Step 6: turn off the light Step 7: care for a silent environment (turn off Television, radio and "do not disturb"-sign at the door) |
|
| usual nursing care | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| daily sleep enhancement nursing protocol | Procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Bedtime in minutes | Protocol of daily bedtime | Daily for up to 14 days from date of giving informed consent to hospital discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Sleeps through the night consistently, 5 point ordinal scale from "severe compromised" to "not compromised" | Subitem of the Outcome 'Sleep' from the Nursing Outcome Classification (NOC) Scale:
| Every second day for up to 14 days from date of giving informed consent to hospital discharge |
| Measure | Description | Time Frame |
|---|---|---|
| Application frequency of the nursing (ritual) protocol | Daily protocol of the received and of the refused interventions of the nursing ritual (frequency) | Every day for up to 14 days from date of giving informed consent to hospital discharge |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hanna Burkhalter, Dr. sc. med. | Center of Sleep Medicine | Principal Investigator |
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| ID | Term |
|---|---|
| D003704 | Dementia |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D019965 | Neurocognitive Disorders |
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| Inappropriate napping, 5 point ordinal scale ranging from "sever" to "none" | Subitem of the Outcome 'Sleep' from the Nursing Outcome Classification (NOC) Scale:
| Every second day for up to 14 days from date of giving informed consent to hospital discharge |
| Cognitive performance (Mini-mental-status-test score) | Mini-mental-status-test score (range 0-30). Any score greater than or equal to 24 points (out of 30) indicates a normal cognition. Below this, scores can indicate severe (≤9 points), moderate (10-18 points) or mild (19-23 points) cognitive impairment | Once in first three days after giving informed consent and another time 7 or 14 days later |
| Physical performance measured with the Handgrip strength test | Handgrip strength in Pascal | Once in first three days after giving informed consent and another time 7 or 14 days later |
| Use of drugs promoting sleep (sedative neuroleptics, hypnotics, sedative antidepressant in the time between 18:00-24:00) (nominal variable: yes or no) | Medical charts review for sedative neuroleptics (e.g. Quetiapine, Haloperidol), sedative antidepressives (e.g. Trazodon), hypnotics present (Benzodiazepines, benzodiazepine-like drugs) in the time between 18:00-24:00 (nominal variable: yes or no ) | day 1,2 and day 6,7 or 13,14 |
| Medical chart review for discharge domicile after hospitalisation (nursing home, home, other institution, other) | Domicile after hospital discharge | day 7 or 14 |
| D001523 | Mental Disorders |