BackgroundHigh noise levels in the intensive care unit (ICU) are a well-known problem. Little is known about the effect of noise on sleep quality in ICU patients. The study aim is to determine the effect of noise on subjective sleep quality.MethodsThis was a multicenter observational study in six Dutch ICUs. Noise recording equipment was installed in 2–4 rooms per ICU. Adult patients were eligible for the study 48 h after ICU admission and were followed up to maximum of five nights in the ICU. Exclusion criteria were presence of delirium and/or inability to be assessed for sleep quality. Sleep was evaluated using the Richards Campbell Sleep Questionnaire (range 0–100 mm). Noise recordings were used for analysis of various auditory parameters, including the number and duration of restorative periods. Hierarchical mixed model regression analysis was used to determine associations between noise and sleep.ResultsIn total, 64 patients (68% male), mean age 63.9 (± 11.7) years and mean Acute Physiology And Chronic Health Evaluation (APACHE) II score 21.1 (± 7.1) were included. Average sleep quality score was 56 ± 24 mm. The mean of the 24-h average sound pressure levels (LAeq, 24h) was 54.0 dBA (± 2.4). Mixed-effects regression analyses showed that background noise (β = − 0.51, p < 0.05) had a negative impact on sleep quality, whereas number of restorative periods (β = 0.53, p < 0.01) and female sex (β = 1.25, p < 0.01) were weakly but significantly correlated with sleep.ConclusionsNoise levels are negatively associated and restorative periods and female gender are positively associated with subjective sleep quality in ICU patients.Trial registrationwww.ClinicalTrials.gov, NCT01826799. Registered on 9 April 2013.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2182-y) contains supplementary material, which is available to authorized users.

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ObjectivesThe number of indicators used to monitor and improve the quality of care is debatable and may influence professionals’ joy in work. We aimed to assess intensive care unit (ICU) professionals’ perceived burden of documenting quality indicator data and its association with joy in work.DesignCross-sectional survey.SettingICUs of eight hospitals in the Netherlands.ParticipantsHealth professionals (ie, medical specialists, residents and nurses) working in the ICU.MeasurementsThe survey included reported time spent on documenting quality indicator data and validated measures for documentation burden (ie, such documentation being unreasonable and unnecessary) and elements of joy in work (ie, intrinsic and extrinsic motivation, autonomy, relatedness and competence). Multivariable regression analysis was performed for each element of joy in work as a separate outcome.ResultsIn total, 448 ICU professionals responded to the survey (65% response rate). The overall median time spent on documenting quality data per working day is 60 min (IQR 30–90). Nurses spend more time documenting these data than physicians (medians of 60 min vs 35 min, p<0.01). Most professionals (n=259, 66%) often perceive such documentation tasks as unnecessary and a minority (n=71, 18%) perceive them as unreasonable. No associations between documentation burden and measures of joy in work were found, except for the negative association between unnecessary documentations and sense of autonomy (β=−0.11, 95% CI −0.21 to −0.01, p=0.03).ConclusionsDutch ICU professionals spend substantial time on documenting quality indicator data they often regard as unnecessary. Despite the lacking necessity, documentation burden had limited impact on joy in work. Future research should focus on which aspects of work are affected by documentation burden and whether diminishing the burden improves joy in work.