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.
"Similar to the field measurement and simulation works presented in previous articles    , researchers have measured the noise levels or studied the sound field of various health care environments. In general, however, their results simply counted the frequency or number of occurrences of different noises together with the corresponding mean and SD values and described the possibilities of avoidable noises to provide noise control solutions, after indicating the dominant sources   . The necessary statistical analysis for the noise distribution, considering the variability of noise distribution over different periods, wards, activities, and routine procedures, is often ignored. "
[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 · 2.00 Impact Factor
"India ED 2 hours 71 68 L Aeq,1h , morning L Aeq,1h , evening Zun and Downey  Illinois, US ED 205 times 56-58 Not reported MacKenzie and Galbrun  Scotland ICU 1 day 55-58 52-55 L Aeq,24h L Aeq,8h , night-time Tsara et al.  Greece ICU 1 week 56-66 55-66 55-62 L Aeq,1h , day L Aeq,1h , evening L Aeq,1h , night McLaren and Maxwell- Armstrong  England Surgical 1 day 59 48 L Aeq,13h , daytime L Aeq,5h , night-time Pope  Oregon, US MSNU 12 hours 62-65 L Aeq,12h , daytime "
"Example waveforms corresponding to each type of hospital noise are shown in Figure 1. Hospital noise recordings were presented at three levels to determine whether increasing decibel levels were associated with progressively worse performance: Low (59 dBA), potentially achievable in a hospital unit; medium (64 dBA), reflecting actual measured average levels (Pope, 2010); and high (69 dBA), which is experienced as approximately twice as loud as the low level of 59 dBA. White noise was used in one of the test conditions as a distraction masker for all participants . "
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