Decibel levels and noise generators on four medical/surgical nursing units
ABSTRACT The study was designed to determine daytime decibel levels on the hospital's four medical/surgical nursing units, daytime decibel levels in patient rooms in corresponding nursing units, whether the nursing unit noise levels differed and to identify what generated noise on those units.
Nurses are responsible for components of patients' physical environments, particularly those that promote patient safety and well-being. Numerous studies have linked hospital noise to negative physiological outcomes for both patients and staff. However, decisions related to managing patient acoustic environments continue to rely on nursing judgment, rather than objective evidence.
Non-human subject, observational/descriptive design.
Using noise dosimeters, weekday day shift decibel levels were measured on four nursing units, sequentially. Measures were made continuously over 12 hours, in three patient rooms and over five minutes every 45 minutes, at the corresponding nurses' station. Noise generators were documented at the nurses' station.
Nursing units had average measured sound levels of 62·2, 63·3, 61·7 and 64·6 decibels, respectively, and were not significantly different from one another (p = 0·07). Nurses' designation of 'quiet', 'typical' and 'noisy' patient rooms was not consistently confirmed by the measured decibel levels. The range of minimum to maximum decibel levels was significantly greater in patient rooms than the nurses' station (54·4 versus 27·7 decibels, p < 0·01), and on average, more than 12 noise generators were identified during any one-five-minute study period.
Patient care areas in today's hospitals are as noisy as a busy office. Nursing judgment is not sufficient to make informed decisions directed towards controlling inpatients' acoustic environment. Standards applied across studies to measure and characterise acoustic environments are urgently needed.
Objective measures, not nursing judgment alone, are required to assess acoustic environments and to direct interventions that improve them.
- SourceAvailable from: Hui Xie[Show abstract] [Hide abstract]
ABSTRACT: This study aimed to investigate the behavior patterns of typical noise sources in critical care wards and relate their patterns to health care environment in which the sources adapt themselves in several different forms. An effective observation approach was designed for noise behavior in the critical care environment. Five descriptors have been identified for the behavior observations, namely, interval, frequency, duration, perceived loudness, and location. Both the single-bed and the multiple-bed wards at the selected Critical Care Department were randomly observed for 3 inconsecutive nights, from 11:30 pm to 7:00 am the following morning. The Matlab distribution fitting tool was applied afterward to plot several types of distributions and estimate the corresponding parameters. The lognormal distribution was considered the most appropriate statistical distribution for noise behaviors in terms of the interval and duration patterns. The turning of patients by staff was closely related to the increasing occurrences of noises. Among the observed noises, talking was identified with the highest frequency, shortest intervals, and the longest durations, followed by monitor alarms. The perceived loudness of talking in the nighttime wards was classified into 3 levels (raised, normal, and low). Most people engaged in verbal communication in the single-bed wards that occurred around the Entrance Zone, whereas talking in the multiple-bed wards was more likely to be situated in the Staff Work Zone. As expected, more occurrences of noises along with longer duration were observed in multiple-bed wards rather than single-bed wards. "Monitor plus ventilator alarms" was the most commonly observed combination of multiple noises.Journal of critical care 08/2013; 28(6). DOI:10.1016/j.jcrc.2013.06.006 · 2.19 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Speech intelligibility and recall were examined in normally hearing and hearing-impaired hospitalized patients. Fifty-two participants completed testing in a sound-attenuated booth. While listening to a recorded male speaker talking at conversational level, participants were asked to identify and remember the last (key) word in each of a series of five sentences presented in hospital noise with or without voices at three decibel levels (59, 64, and 69 dBA). Noise level and sentence context had the largest impact on key word identification (p < .001). Noise level had the largest impact on key word recall (p < .001). Type of hospital noise and hearing loss also significantly influenced performance on both measures. These findings have implications for healthcare providers communicating with hospitalized patients. © 2013 Wiley Periodicals, Inc. Res Nurs Health.Research in Nursing & Health 06/2013; 36(3). DOI:10.1002/nur.21540 · 1.16 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The aims of the study were to examine the studies related to hospital noise in intensive care units (ICUs) to understand the sources and effects of noise and to describe best practices and common problems in the varying methods commonly applied to reduce the noise level. The ISI Web of Knowledge and PubMed were used to search original research articles to obtain articles related to hospital ICU noise analysis. This review article analyzes the 29 extant studies related to noise in ICUs. Significant opportunities exist to improve methodologies to study noise levels to reduce noise in hospital ICUs. Many previous studies have used inconsistent methodologies with poorly defined parameters that make it difficult to compare results. Our work points out common pitfalls in the recording and sharing of hospital acoustic parameters and also points to the paucity of important economic considerations in extant studies. These results can be helpful for future research in this area. Many past salutary interventions-including educational noise reduction programs, behavioral modification using sound detection equipment, and low- as well as high-cost environmental alterations-do not generally appear to be adequate to minimize noise to levels for hospital rooms specified by international agencies. But a potentially important clue for future work involves the finding that as the number of patients and staff of the ICU increases, noise levels appear to also increase.Journal of critical care 10/2011; 27(5):522.e1-9. DOI:10.1016/j.jcrc.2011.09.003 · 2.19 Impact Factor