A Sleep Bundle Intervention to Promote Sleep Quality and Reduce Incidence Rate of Delirium among Critically Ill Patients

Asmaa A. Temraz¹, Naglaa M. El-Mokadem^{2, 3,} and Shaimaa E. Abdullah⁴

¹Teacher in the High Technical Institute of Nursing

²Professor of Critical Care and Emergency Nursing, Faculty of Nursing- Galala University, Suez, Egypt

³Professor of Critical Care and Emergency Nursing, Faculty of Nursing- Menoufia University, Menoufia, Egypt

⁴Assistant Prof. of Critical Care and Emergency Nursing, Faculty of Nursing -Menoufia University, Menoufia, Egypt

Cite this paper:
Asmaa A. Temraz, Naglaa M. El-Mokadem and Shaimaa E. Abdullah. A Sleep Bundle Intervention to Promote Sleep Quality and Reduce Incidence Rate of Delirium among Critically Ill Patients. American Journal of Nursing Research. 2026; 14(2):27-36. doi: 10.12691/ajnr-14-2-2

Abstract

Background: Sleep disruption is strongly linked to delirium, a common and serious complication in ICU patients, associated with longer hospital length of stays, higher mortality, and long-term cognitive decline. Sleep bundle interventions are multifaceted strategies designed to enhance sleep quality and reduce the risk of delirium in intensive care units (ICUs). Purpose: This study aimed to evaluate the effectiveness of a sleep bundle intervention to promote sleep quality and reduce incidence rate of delirium among critically ill patients. Setting: Medical, Surgical, and Anesthesia ICUs in a tertiary care hospital. Sample: A convenience sample of 120 critically ill patients. Design: Quasi-experimental design. Instruments: Demographic and clinical data sheet; Sleep Quality Scale Index; Richards-Campbell Sleep Questionnaire; Intensive Care Delirium Screening Checklist (ICDSC); Confusion Assessment Method for the ICU (CAM-ICU); and APACHE II scale. Results: the intervention group showed significantly better sleep quality (31.78 ± 13.86) compared with the control group (54.38 ± 10.93) (p < 0.001). The incidence of delirium was significantly lower in the intervention group (0.33 ± 0.91) than the control group (0.83 ± 1.29) post-intervention (p = 0.03). The ICU length of stay was significantly shorter in the intervention group (4.15 ± 1.27 days) compared with the control group (4.75 ± 1.64 days; p < 0.05). There was a significant positive correlation between severity of illness and delirium incidence rate in the study group (r = 0.619, p < 0.001) and the control group (r = 0.689, p < 0.001). Co-morbidities also correlated positively with delirium in the study group (r = 0.375, p < 0.001) and control groups (r = 0.617, p < 0.001). Conclusion: Sleep bundle intervention effectively improved sleep quality, reduced delirium incidence rate, and shortened ICU length of stay among critically ill patients. Recommendation: Integrating sleep bundle intervention into routine ICU care is recommended to enhance clinical outcomes among critically ill patients.

Keywords:
Critically ill patients Delirium Sleep disturbance Sleep bundle intervention Sleep quality

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