Online Data Supplement Perceptions and Practices Regarding Sleep in the ICU: A Survey of 1,223 Critical Care Providers Biren B. Kamdar, MD, MBA, MHS, Melissa P. Knauert, MD, PhD, Shirley F. Jones, MD, Elizabeth C. Parsons, MD, MSc, Sairam Parthasarathy, MD, Margaret A. Pisani, MD, MPH for the Sleep in the ICU (SLEEPii) Task Force
SLEEP IN THE INTENSIVE CARE UNIT SURVEY 1. Please document your role in providing care in the intensive care unit Nurse Nurse in training Advanced Practice Nurse (Nurse practitioner, clinical nurse specialist, nurse anesthetist) Physician s Assistant Pulmonary-Critical Care Fellow Surgical Critical Care Fellow Attending Physician Cardiology Fellow 2. How many years of experience have you had working in an intensive care unit environment? 3. What is your age in years? 4. What is your gender? Male Female 5. In what Country do you practice? United States Great Britain France Australia New Zealand Spain Italy China India Brazil Korea Canada Other 6. What is the zip code where you practice in the intensive care unit? 7. Please check your primary area of expertise. Internal Medicine-Pulmonary & Critical Care Internal Medicine-Critical Care Internal Medicine-General Internal Medicine Internal Medicine-Cardiology Surgery-Critical Care Anesthesiology E2
Emergency Medicine Neurology-Neurocritical Care Family Medicine Other 8. What is your practice setting? Check all that apply. Academic Medical Center University Hospital Private Hospital Urban, Public Hospital Veterans Affairs Hospital Other 9. Are you the director of an intensive care unit? Yes No 10. When do you typically spend the majority of your hours working in the ICU? Days Nights 50% Days and 50% Nights 11. How much of your clinical practice is spent caring for patients in the ICU? 0-10% 10-25% 25-50% 50-75% 75-100% 12. How many ICU beds does the unit you work in have? E3
13. How many different ICU's does your hospital have? Check all that apply Medical Surgical Cardiac Medical-Surgical Neurosurgical Cardiothoracic Surgery Burn 14. How many beds does the hospital you practice in have? 15. On average how many hours in a 24-hour period do you think your patients sleep while in the ICU? 16. Rate the overall QUALITY of your patients sleep while they are in the ICU? Very Poor (1) Poor (2) Fair (3) Good (4) Very Good (5) Excellent (6) 17. Please indicate the level of importance that ICU patients sleep (both quantity and quality) while under your care? Unimportant (1) 1 (2) 2 (3) 3 (4) 4 (5) Extremely Important (6) 18. Do you believe that if your patients sleep poorly while critically ill it could affect their recovery? Yes No Maybe Don't know 19. Which aspects of a patient s recovery do you think could be adversely affected by poor sleep in the ICU? (Check ALL that apply) Ability to fight off infection Ability to heal wounds Liberation from mechanical ventilation Development or persistence of delirium Hospital length of stay Ability to participate in physical therapy Development of depression Survival Don t know E4
20. What is the ONE thing that you believe may improve your patients sleep in the ICU? Medication prescribed for sleep Noise control Keep patients awake during the day so they are more tired for sleep at night Keeping them physically active during the day so they are more tired for sleep at night Keeping the ICU room dark at night and bright during the day Allowing patients blocks of uninterrupted sleep time None of the above Don t know Other 21. How many HOURS per DAY specifically dedicated for sleep do you believe is SUFFICIENT for your ICU patients? 22. How many hours of dedicated time for sleep do you believe can be REALISTICALLY ACHIEVED in your ICU patients? 23. What percentage of patients receive medication specifically to help them sleep while they are in your ICU? 24. Please rank the following items from MOST important to LEAST important as disturbances of patient sleep in your ICU. Rank 1 as being the MOST important and 12 being the LEAST important. (YOU CAN CLICK AND DRAG ITEMS IN ORDER OF YOUR PREFERENCE) Medication administration Measuring vital signs Performance of radiographic studies Suctioning of airway secretions/ventilator adjustments Bathing Physical examination by providers Wound care Noise levels in the ICU Light levels in the ICU Visitation from family and friends Patient repositioning Other 25. Does your ICU have a protocol aimed at PROMOTING SLEEP for your ICU patients? Yes No Don't Know 26. How long have you had a protocol for sleep promotion in your ICU? Please respond in years. E5
27. Please rate how certain you are that you CAN PERFORM each of the following tasks described below Assess whether your ICU patients are sleeping enough Control the ICU environmental lighting conditions for your patients to allow them to sleep Control the environmental noise levels for your ICU patients to allow them to sleep Adjust the mechanical ventilator or BiPAP settings to make it more comfortable to allow your patients to sleep Delay non-emergency disturbances of stable ICU patients in order to allow them time to sleep (e.g., administering medications, checking vitals signs, bathing, etc.) Adhere to a sleep protocol designed for ICU patients that requires clustering of care Temporarily suspend visitation from family and friends to allow your ICU patients time to sleep Create conditions in your ICU to allow your stable patients dedicated time to sleep at night You can absolutely never do this 2 3 4 5 6 7 8 9 You can do this absolutely every time E6