Are noise reduction interventions effective in adult ward settings? A systematic review and meta analysis

Abstract

International studies show that high levels of environmental noise in hospitals disturb sleep. We know little about effective interventions to address this problem. We aimed to review primary research that tested noise-reduction interventions in ward-settings. Design: Systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Data Sources: Health-related and acoustic databases searched from inception to 2017 with no language restrictions. Review methods: Experimental, quasi-experimental and observational studies assessing the effect of interventions on patient outcomes and/or environmental noise were included. Results: 834 records were identified with 9 meeting inclusion criteria. Data from 6 studies were pooled. Quality appraisal showed that the level of evidence was generally weak. A random effects meta-analysis determined that a synthesised estimate for the standardised mean difference in total hours sleep (no intervention -intervention) was -0.11 hours (95% CI -0.46 to 0.25 hours; p=0.556), with moderate statistical heterogeneity. A synthesised estimate for the standardised mean difference in awakenings (no intervention -intervention) was 0.05 (95% CI -0.20 to 0.29; p=0.715), with negligible statistical heterogeneity. A random effects meta-analysis determined that a synthesised estimate for the odds ratio for disturbed nights (no intervention: intervention) was 0.75 (95% CI 0.55 to 1.01; p=0.059), with low statistical heterogeneity. Conclusions: Individual studies show that noise reduction interventions are feasible and have the potential to improve patients' sleep experiences. However meta-analyses show insufficient evidence to support their use. Robust studies are required to identify effective interventions to address this significant and ubiquitous problem. AbstractObjective: High levels of environmental noise in hospitals disturbs sleep. We aimed to identify, critically appraise and summarise primary research that reports studies that tested interventions to reduce night-time noise levels in ward-settings. Design: Systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. with no language restrictions. Review methods: Experimental, quasi-experimental and observational study designs assessing the effect of noise reduction interventions on patient outcomes and/or environmental noise levels were included. Two reviewers independently conducted a quality appraisal using a published framework. Results: In total, 834 records were identified with nine studies meeting inclusion criteria. Quality appraisal showed that the level of evidence was generally weak. A range of noise reduction interventions were identified: one study implemented a single intervention, whilst the remainder were complex, multi-faceted interventions. Findings from individual studies showed mixed results but preliminary evidence suggests that noise reduction interventions can reduce environmental noise leve...

“Noise Factory”: A qualitative study exploring healthcare providers’ perceptions of noise in the intensive care unit

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“…As a result, many medical errors and patient safety concerns have increased within ICUs (Choiniere, 2010;Kol et al, 2015;Konkani et al, 2014;Morrison, Haas, Shaffner, Garrett, & Fackler, 2003). In meta-analysis, it was found that there was a relationship between high rates of burnout among healthcare providers and worsening patient safety (Garside et al, 2018). One study also found that modifiable risk factors in the ICU environment were related to the intention to leave the job (Swamy et al, 2019).…”

“…Therefore, identifying the sources of noise and preventing noise in the ICU are important in order to increase patient safety, decrease medical errors, and provide a healthy work environment for staff. It was specified that some noise reduction strategies were effective in the short-term only (Garside et al, 2018). Some older literature has discussed environmental noise in the ICU as reported by patients, such as staff activities, medical equipment, air-conditioning, bin lids slamming (Ryherd et al, 2008).…”

Aesthetics sets patients ‘free’ to recover during hospitalization with a neurological disease. A qualitative study

“…The evidence is clear. Noisiness has extensive consequences to ill people (Applebaum et al, 2016 ; Delaney et al, 2019 ; Garside et al, 2018 ; Laursen et al, 2014 ; Oleksy & Schlesinger, 2019 ). Our study supports previous studies on how a noisy environment is intertwined with a patient’s possibility to experience inner peace during hospitalization.…”

Interventions to improve inpatients' sleep quality in intensive care units and acute wards: a literature review

“…Our review found that both ICU and AW settings share similarities and differences in sleep-promoting strategies as well as sleep-inhibiting factors. In terms of sleep-promoting strategies, both settings share similarities in synchronization of care [implementing multiple tasks at one visit, for example, administration of painkillers and checking observations at the same time] to minimize sleep disturbances (Dolan et al, 2016;Garside et al, 2018;Altman et al, 2018). Both settings also share similarities in using medicine to aid sleep.…”