Summary: | A preliminary study was designed to assess the feasibility of testing the effect of earplug use, as a nursing intervention, on the sleep of critically ill patients using polysomnography. This study was done as a necessary first step in determining the feasibility of a larger, adequately powered study testing the same intervention as a cost-effective, non-invasive means of promoting sleep in the critically ill population. A single subject repeated measures design was used, and subjects served as their own controls. Two participants completed the study protocol. Analysis of the study data resulted in a number of recommendations for future studies. First, it was demonstrated that a larger study testing the effect of earplug use in critically ill adults is needed, and that it is feasible to conduct such a study i f sufficient funding is obtained. It is also suggested that the use of a research facilitator be considered to resolve some of the barriers encountered in recruitment of subjects, and to also overcome some of the logistical issues with nursing and medical support for the project. Access to interpretive services needs to be available for such a study to be successfully implemented in the same setting. It is further recommended that noise levels are measured concurrently with the polysomnographic sleep measurement. Planning for a future study must include careful consideration of eligibility criteria. Specifically, it is recommended that an upper limit of morphine equivalents of 30 micrograms per kilogram per hour be set. Finally, qualitative data regarding the participants' subjective experience of sleep should be collected to further inform the study.
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