Decibel levels and noise generators on four medical/surgical nursing units

Department of Veterans Affairs Portland Medical Center, Portland, OR 97239, USA.
Journal of Clinical Nursing (Impact Factor: 1.23). 09/2010; 19(17-18):2463-70. DOI: 10.1111/j.1365-2702.2010.03263.x
Source: PubMed

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.

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