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1. Journal of Surgical Research Discussion
Journal of Surgical Research DiscussionJournal of Surgical Research DiscussionDetails:The
purpose of this assignment is to evaluate empirical research as it relates to your PICOT
question.General Requirements:Doctoral learners are required to use Prepare this
assignment according to the guidelines found in the APA Style Guide, located in the Student
Success Center. An abstract is not required.This assignment uses a rubric. Please review the
rubric prior to beginning the assignment to become familiar with the expectations for
successful completion.You are required to submit this assignment to Turnitin. Please refer
to the directions in the Student Success Center.Directions:Using feedback from your
instructor on your PICOT question and annotated bibliographies, revise your PICOT
question and annotations.Using your annotations, write a 1,250-1500 word paper, in which
you evaluate the literature, including the study conclusions, merits, and shortcomings. Your
evaluation should address the following questions, and your conclusions should be ed with
appropriate citations.In which studies are the themes of the literature review similar?
Different?In which studies do the data the conclusion?In which studies do the conclusions
answer the research question?What questions would you ask the authors?How might the
evidence in these studies be of use to refining you PICOT question or perhaps formulating
or implementing your DPI project?ORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE
PAPERSRunning head: ANNOTATED BIBLIOGRAPHY Annotated Bibliography for DPI
Project Julie A. Braylock Grand Canyon University: DNP 801 August 17, 2018 1 ANNOTATED
BIBLIOGRAPHY 2 Annotated Bibliography for DPI Project First Article Le, A., Friese, R. S.,
Hsu, C., Wynne, J. L., Rhee, P., & O’Keeffe, T. (2012). Sleep disruptions and nocturnal nursing
interactions in the intensive care unit. Journal of Surgical Research, (2), 310. The article
addresses the long-standing problem of patient’s in the ICU area being sleep deprived due
to increased interaction in that area. Various specialized ICU’s were looked at during the
night shift for nursing interactions between the hours of 10 pm and 6 am. It was
hypothesized that patient’s in these areas suffered from sleep disruption from all of nursing
interaction during the night shift. The data collect was done in this cohort study by direct
observation. The population was over 200 patients in various ICU’s in an academic hospital.
One of the main weaknesses of the study is that nurses were recording so this could
introduce some bias into the study. It was also noted that there was a difference in the
acuity of each ICU so that can make it challenging to obtain consistent data due to acuity and
census. Overall, the article was well presented and could be found to have validity. Second
Article Nannapaneni, S., Ramar, K., Morgenthaler, T., Elmer, J., & Lee, S. (2013). Sleep

2. fragmentation and deprivation in critically ill patients – Is noise a factor? Sleep Medicine,
14e217-e218. doi: 10.1016/j.sleep.2013.11.520 This article’s focuses on correlating the
level of noise and the interruption of sleep in the ICU. The increased noise may lead to ICU
delirium secondary to the lack of sleep. This could in ANNOTATED BIBLIOGRAPHY 3 turn
lengthen a patient’s stay and lead to mortality. The study looked at various noise levels and
factors affecting those noise levels. This mixed methodology study used surveys to collect
data. The setting was in the 24bed Medical ICU in the Mayo Clinic in Rochester Minnesota.
Weaknesses noted was there was no time span for data collection was noted. Journal of
Surgical Research DiscussionThis may not give a realistic picture of the data. The article was
well presented and does bring up valid questions for further research. Third Article Tembo,
A. C., Parker, V., & Higgins, I. (2013). The experience of sleep deprivation in intensive care
patients: Findings from a larger hermeneutic phenomenological study. Intensive & Critical
Care Nursing, 29310-316. doi: 10.1016/j.iccn.2013.05.003 The authors of this study do a
great job on highlighting the effects of sleep disruptions and sedation interruption in the
ICU. In reading this study it is now understood that there can be some lasting effects from
lack of sleep leaving the ICU. The participants discussed having nightmares and craving
sleep. This can cause some mental, physical, and emotional instability. This empirical study
was well presented. Face-to-face interviews were conducted on patients that were
discharged from the ICU two weeks out. The age ranged from 20-76 so that gave a good
population mix for data collection. There were even some interviews conducted 6-8 months
post discharge. This was also good for data collection and the study’s validity. Fourth Article
Nesbitt, L., & Goode, D. (2014). Review: Nurses perceptions of sleep in the intensive care
unit environment: A literature review. Intensive & Critical Care Nursing, 30231-235. doi:
10.1016/j.iccn.2013.12.005 ANNOTATED BIBLIOGRAPHY 4 Sleep deprivation in the ICU
continues to be an ongoing issue for patients. According to the authors, the issue could be
due in large part to the lack of understanding on the nurse’s part of noise control and sleep
interruption. Assessment of nurses’ perception of prioritizing nursing interactions. The
study also explored nursing knowledge on interventions to promote sleep. The empirical
study was a literature review of 25 articles that met inclusion criteria. It was concluded that
nurses need education and training on specific protocols for sleep induction or promotion.
It is also noted that further empirical research needs to be conducted on the education
programs and sleep assessment tool. Fifth Article Boesen, H. C., Andersen, J. H., Bendtsen, A.
O., & Jennum, P. J. (2016). Sleep and delirium in unsedated patients in the intensive care
unit. Acta Anaesthesiologica Scandinavica, 60(1), 59-68. doi:10.1111/aas.12582 This study
was aimed at assessment of quality of sleep in a mechanically ventilated patient who is not
sedated. It is hypothesized that there may be a correlation between the quality of sleep and
delirium. Polysomnography was used to measure the quality of sleep. There are many
things that can disrupt sleep patterns like disease process, high noise levels, visitor traffic,
testing and nursing care. The study was well presented. The authors did a great job in
presenting the evidence. There could have been a larger population used in the study. There
was good evidence on the use of benzodiazepines and opioids and the correlation to
delirium as well. Sixth Article ANNOTATED BIBLIOGRAPHY 5 Yazdannik, A. R., Zareie, A.,
Hasanpour, M., & Kashefi, P. (2014). The effect of earplugs and eye mask on patients’

3. perceived sleep quality in intensive care unit. Journal of Surgical Research
DiscussionIranian Journal of Nursing & Midwifery Research, 19(6), 673. The author outlines
how noise and light are the biggest culprits of sleep disruption in the ICU. It is almost
inevitable that the patient in the critical care unit will not be able to rest properly largely
due to these two factors. As a result, there was a study conducted for the effects of earplugs
and eye shield use and quality sleep. This was a cross-over clinical trial that included 50
patients from the ICU from a local hospital. The patients were picked randomly and
separated into two groups which speaks volumes to validity and bias. It was concluded that
though the use of the earplugs and eye shield was a cost effective was to help alleviate sleep
disruption, there needed to be further research to prove whether there was a real effect on
quality of sleep. Briefly describe what you have learned from feedback given by your
instructor regarding your PICOT question. How will you frame your PICOT differently
moving forward? Be specific about what components, if any, that you will change. The input
that I received for my PICOT question was to be more specific about the patient outcomes.
So I focused on the issue at hand, the quality of rest for the patient. It was also suggested
that I be specific about the time for the data collection. Both of those suggestions were very
relevant and drove me to look at my PICOT question again. I thank the instructor and my
fellow classmates for their input. PICOT Question In adult critical care patients, how does a
scheduled quiet time, compared with not implementing a scheduled quiet time, improve
patient outcomes? Population: Adult critical care patients Intervention: Implementing a
scheduled quiet time Comparison: Not implementing a scheduled quiet time Outcome:
Improved patient outcomes Revised PICOT In adult critical care patients in the ICU, how
does a scheduled quiet time, compared with not implementing a scheduled quiet time,
improve patient rest periods? Population: Adult critical care patients Intervention:
Implementing a scheduled quiet time Comparison: Not implementing a scheduled quiet
time Outcome: Improved quality of patient rest periods Time: Over a three-month period
Journal of Surgical Research Discussion