What do patterns of noise in a teaching hospital and nursing home suggest?
ABSTRACT Noise pollution is known to cause deleterious effects on human health and may especially affect frail elderly patients with poor mental and physiologic reserve.
(i) to learn levels and time- and place-patterns of noise in an urban community teaching hospital (TH) and affiliated urban nursing home (NH); (ii) to compare levels and patterns of noise in both institutions.
Recordings were obtained in three areas of the TH: emergency room (ER), intensive care units (ICU), and medical-surgical floors (HF) - nurses' stations and patients' rooms. On nursing home floors (NHF), noise levels were recorded at nurses' stations and in patients' rooms. In all areas of the hospital and NH, noise levels were in range of 55-70 dB and exceeded the 40-50 dB limit recommended by the EPA. In ER and ICU, noise level was higher on weekdays than weekends. In ICU and on HF, noise level was higher during mid-day hours during mornings and evenings. The highest noise level was recorded in ER followed by ICU and HF. On HF, nurses' stations were noisier than patients' rooms. Noise level was higher in the TH than in the NH. On NHF, noise level was similar on weekdays and weekends. Noise was stronger at nurses' stations than in patients' rooms and stronger in the mornings and evenings than during mid-day hours. Patterns of noise followed the human factor activities observed in both facilities.
The level of noise in both facilities was above the recommended limit and presents an environmental stressor for a frail elderly patient. With transfer from NH to TH exposure to this stressor is increased. Time- and place-patterns of noise in both institutions suggest that human factor is a major source of noise pollution. This pollution is, therefore, potentially modifiable.
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ABSTRACT: To determine the relationship between quality of life (QOL) and environmental factors of temperature, noise, and lighting in nursing home residents with severe dementia. Cross-sectional, observational, analytical. Eight public, long-term care nursing homes in the province of Girona, Spain. Random sample of 160 nursing home residents with severe dementia. Functional and cognitive impairment, pain, neuropsychiatric disturbances, and QOL were determined using standardized instruments. Temperature, noise, and lighting in bedrooms, dining rooms, and living rooms were measured in the morning and afternoon using a multifunction environment meter in a standardized manner. Adjusted multivariate linear regression models demonstrated that environmental measures were independently associated with QOL and related factors. High temperature in the bedroom was associated with lower QOL (standardized β = 0.184), high noise levels in the living room were associated with low behavioral signs of social interactions (β = 0.196), and low lighting levels in the bedroom were associated with number of signs of negative affective mood (β = -0.135). The QOL of nursing home residents with severe dementia was related to environmental factors such as temperature, noise, and lighting. The monitoring of these environmental factors may improve these individuals' QOL.Journal of the American Geriatrics Society 06/2012; 60(7):1230-6. DOI:10.1111/j.1532-5415.2012.04040.x · 4.22 Impact Factor
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ABSTRACT: A large and growing number of people with dementia are being cared for in long-term care. The empirical literature on the design of environments for people with dementia contains findings that can be helpful in the design of these environments. A schema developed by Marshall in 2001 provides a means of reviewing the literature against a set of recommendations. The aims of this paper are to assess the strength of the evidence for these recommendations and to identify those recommendations that could be used as the basis for guidelines to assist in the design of long term care facilities for people with dementia. The literature was searched for articles published after 1980, evaluating an intervention utilizing the physical environment, focused on the care of people with dementia and incorporating a control group, pre-test-post-test, cross sectional or survey design. A total of 156 articles were identified as relevant and subjected to an evaluation of their methodological strength. Of these, 57 articles were identified as being sufficiently strong to be reviewed. Designers may confidently use unobtrusive safety measures; vary ambience, size and shape of spaces; provide single rooms; maximize visual access; and control levels of stimulation. There is less agreement on the usefulness of signage, homelikeness, provision for engagement in ordinary activities, small size and the provision of outside space. There is sufficient evidence available to come to a consensus on guiding principles for the design of long term environments for people with dementia.International Psychogeriatrics 11/2010; 22(7):1084-96. DOI:10.1017/S1041610210000438 · 1.89 Impact Factor