PDF(Pubmed)
Abstract：
BACKGROUND: Adequate sleep in hospitalised children is important for a variety of physiological and psychological processes associated with growth, development, and recovery from illness and injury. Hospitalisation often prioritises clinical care activities at the expense of age-appropriate sleep. Nurses and the wider healthcare team contribute to this paradox. However, through conscious practice and partnering with mothers, nurses are able to enact change and promote sleep.
OBJECTIVE: To adopt, adapt or contextualise existing guidelines to develop an evidence-based practice guideline to promote sleep-friendly ward environments and routines facilitated by nurses, and in partnership with mothers.
METHODS: A six-step methodology for guideline adaptation was followed, as recommended by the South African Guidelines Excellence project: (1) existing guidelines and protocols were identified and (2) appraised using the AGREE II instrument; (3) an evidence base was developed; (4) recommendations were modified, (5) assigned levels of evidence and grades of recommendation; and (6) end user guidance was developed. Expert consultation was sought throughout.
RESULTS: Existing relevant guidance comprised 61 adult-centric recommendations. Modification of the evidence base led to six composited recommendations that facilitate sleep in hospitalised children: (1) prioritising patient safety; (2) collaborating with the mother or caregiver to promote sleep; (3) coordinating ward routine and (4) environment to improve sleep; (5) work with clinical and non-clinical staff; and (6) performing basic sleep assessments. Practice recommendations were aligned to the South African regulatory framework for nursing.
CONCLUSIONS: Hospitalisation is a time of physiological and psychological dysregulation for children, which is amplified by poor sleep in a hospital. Nurses have the opportunity to promote sleep during hospitalisation by implementing this African-centric guideline in partnership with mothers.
OBJECTIVE: To adopt, adapt or contextualise existing guidelines to develop an evidence-based practice guideline to promote sleep-friendly ward environments and routines facilitated by nurses, and in partnership with mothers.
METHODS: A six-step methodology for guideline adaptation was followed, as recommended by the South African Guidelines Excellence project: (1) existing guidelines and protocols were identified and (2) appraised using the AGREE II instrument; (3) an evidence base was developed; (4) recommendations were modified, (5) assigned levels of evidence and grades of recommendation; and (6) end user guidance was developed. Expert consultation was sought throughout.
RESULTS: Existing relevant guidance comprised 61 adult-centric recommendations. Modification of the evidence base led to six composited recommendations that facilitate sleep in hospitalised children: (1) prioritising patient safety; (2) collaborating with the mother or caregiver to promote sleep; (3) coordinating ward routine and (4) environment to improve sleep; (5) work with clinical and non-clinical staff; and (6) performing basic sleep assessments. Practice recommendations were aligned to the South African regulatory framework for nursing.
CONCLUSIONS: Hospitalisation is a time of physiological and psychological dysregulation for children, which is amplified by poor sleep in a hospital. Nurses have the opportunity to promote sleep during hospitalisation by implementing this African-centric guideline in partnership with mothers.
摘要：
背景：住院儿童的充足睡眠对于与生长相关的各种生理和心理过程很重要，发展,从疾病和伤害中恢复。住院通常优先考虑临床护理活动，但要牺牲适合年龄的睡眠。护士和更广泛的医疗团队促成了这一悖论。然而,通过有意识的实践和与母亲的合作，护士能够制定改变和促进睡眠。
目标：采用，调整或情境化现有指南，以制定基于证据的实践指南，以促进护士促进睡眠友好的病房环境和常规，并与母亲合作。
方法：遵循指南适应的六步方法，根据南非准则卓越项目的建议：（1）确定了现有的准则和协议，（2）使用AGREEII工具进行了评估；（3）建立了证据基础；（4）修改了建议，(5)指定的证据水平和推荐等级;以及(6)制定最终用户指南。自始至终都寻求专家咨询。
结果：现有的相关指南包括61个以成人为中心的建议。证据基础的修改导致促进住院儿童睡眠的六个综合建议：（1）优先考虑患者安全；（2）与母亲或护理人员合作以促进睡眠；（3）协调病房常规和（4）改善睡眠的环境；（5）与临床和非临床工作人员合作；（6）进行基本睡眠评估。实践建议与南非护理监管框架保持一致。
结论：住院是儿童生理和心理失调的时期，医院睡眠不足会加剧这种情况。护士有机会通过与母亲合作实施以非洲为中心的指南来促进住院期间的睡眠。
目标：采用，调整或情境化现有指南，以制定基于证据的实践指南，以促进护士促进睡眠友好的病房环境和常规，并与母亲合作。
方法：遵循指南适应的六步方法，根据南非准则卓越项目的建议：（1）确定了现有的准则和协议，（2）使用AGREEII工具进行了评估；（3）建立了证据基础；（4）修改了建议，(5)指定的证据水平和推荐等级;以及(6)制定最终用户指南。自始至终都寻求专家咨询。
结果：现有的相关指南包括61个以成人为中心的建议。证据基础的修改导致促进住院儿童睡眠的六个综合建议：（1）优先考虑患者安全；（2）与母亲或护理人员合作以促进睡眠；（3）协调病房常规和（4）改善睡眠的环境；（5）与临床和非临床工作人员合作；（6）进行基本睡眠评估。实践建议与南非护理监管框架保持一致。
结论：住院是儿童生理和心理失调的时期，医院睡眠不足会加剧这种情况。护士有机会通过与母亲合作实施以非洲为中心的指南来促进住院期间的睡眠。
