Comparison of staff and family perceptions of causes of noise pollution in the Pediatric Intensive Care Unit and suggested intervention strategies

Abstract

Noise and excessive, unwanted sound in the Pediatric Intensive Care Unit (PICU) is common and has a major impact on patients’ sleep and recovery. Previous research has focused mostly on absolute noise levels or included only staff as respondents to acknowledge the causes of noise and to plan for its reduction. Thus far, the suggested interventions have not ameliorated noise, and it continues to serve as a barrier to recovery. In addition to surveying PICU providers through internet-based software, patients’ families were evaluated through in-person interviews utilizing a pretested instrument over 3 months. Families of patients admitted for more than 24 h were considered eligible for evaluation. Participants were asked to rank causes of noise from 1 to 8, with eight being highest, and identified potential interventions as effective or ineffective. In total, 50 families from 251 admissions and 65 staff completed the survey. Medical alarms were rated highest (mean ± standard deviation [SD], 4.9 ± 2.1 [2.8-7.0]), followed by noise from medical equipment (mean ± SD, 4.7 ± 2.1 [2.5-6.8]). This response was consistent among PICU providers and families. Suggested interventions to reduce noise included keeping a patient's room door closed, considered effective by 93% of respondents (98% of staff; 88% of families), and designated quiet times, considered effective by 82% (80% of staff; 84% of families). Keeping the patient's door closed was the most effective strategy among survey respondents. Most families and staff considered medical alarms an important contributor to noise level. Because decreasing the volume of alarms such that it cannot be heard is inappropriate, alternative strategies to alert staff of changes in vital signs should be explored.

<p>Assessment Of Ambient-Noise Exposure Among Female Nurses In Surgical Cardiac Intensive Care Unit</p>

“…These studies support our findings, and revealthat ambient noise in the ICU exceeds WHO guidelines 1,20. Though it has been shown that levels significantly exceeded the recommended standards, values were 40–60 dB(A) with no significant day/night-shift variation 8,21,22…”

“…Nonetheless, it is considered a preventable injury when produced by occupational noise 7. Recent Swedish studies found that noise levels in ICUs remain high and that only 10% of ICU staff decrease volumes on alarms, monitors and ventilators during the day8…”

Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle

“…54 Although equipment alarms likely contribute significantly to noise pollution, this was not an easily modifiable source in our PICU. 55 Therefore, we focused on other easy-to-perform tasks that could reduce noise pollution impacting sleep quality. Examples of tasks incorporated in the Evening BED to emphasize reduction of noise pollution were speaking with a quiet voice, grouping vital sign and nursing care activities, closing patient room doors, setting the staff pagers and phones to vibration mode, and turning the television off at night.…”

The Association between Noise Annoyance and General Health among Iranian Nurses at Tabriz Pediatric Hospital

“…Research shows that the subjective annoyance of the sound increases upon raising the sound level. However, at low sound levels, other factors determine whether annoyance occurs (2,3). Noise exerts psychological and physiological effects on humans (4).…”