Daily Sleep Enhancement for Hospitalized People With Dementia Following a Nursing Protocol

Study Overview
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Brief Summary
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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.

Official Title
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Daily Sleep Enhancement for Hospitalized People With Dementia Following a 7 Step Nursing Protocol: a Quasi-experimental Pilot Study

Conditions
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Sleep, Dementia

Intervention / Treatment
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* Procedure: daily sleep enhancement nursing protocol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of dementia of any severity and type Allocation to geriatric rehabilitation treatment Exclusion Criteria: sleep related respiratory or moving related disorders or Parasomnia delirium end of life care

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: daily sleep enhancement nursing protocol<br>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) | Procedure: daily sleep enhancement nursing protocol<br> <br> |
| No Intervention: usual nursing care<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | 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 | 

Secondary Outcome Measures

| Outcome Measure | 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: severe compromised substantial compromised moderate compromised mild compromised not compromised | Every second day for up to 14 days from date of giving informed consent to hospital discharge | 
| Inappropriate napping, 5 point ordinal scale ranging from sever to none | Subitem of the Outcome 'Sleep' from the Nursing Outcome Classification (NOC) Scale: severe substantial moderate mild none | 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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geriatric nursing