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: 1.26). 09/2010; 19(17-18):2463-70. DOI: 10.1111/j.1365-2702.2010.03263.x
Source: PubMed


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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    • "Similar to the field measurement and simulation works presented in previous articles [9] [10] [11] [12], 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 [5] [13] [14]. 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. "
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    • "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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    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.
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