Noise in the Pediatric Intensive Care Unit

“…Regression analysis did not show that noise was generally a factor causing discomfort. As in the ICU, 22 some patients recovering from anaesthesia may have found some noises reassuring rather than alarming. Pain remains the major cause of discomfort in our unit despite treatment plans for pain management.…”

Section: Discussionmentioning

confidence: 99%

Noise in the postanaesthesia care unit

Allaouchiche

Duflo

Debon

et al. 2002

British Journal of Anaesthesia

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“…More recently, new standards assert that the average noise levels inside NICU incubators should not exceed 60dB (7,8). Subsequent work similarly recommended that NICU sound limitations of 50 to 55dB on average, with a 1-second peak of 70dB, should be implemented (5).…”

Section: Discussionmentioning

confidence: 99%

“…In one study, Surenthiran et al demonstrated that the proximity of the post-nasal space to the inner ear is enough to allow noise to be transmitted, and may cause cochlear damage, and therefore hearing loss in infants receiving the higher flow rates CPAP (7). Furthermore, Berens et al addressed concerns about the level of the noise produced by HFOV equipment inside pediatric intensive care units (8). While using HFOV is common practice inside a NICU, and despite the high noise levels produced by the HFOV machine itself (9), there is little information available on the magnitude of the noise levels produced by the HFOV within different NICU setups.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Incubators on Noise Transmission Produced by High-Frequency Oscillatory Ventilator Inside the Neonatal Intensive Care Unit

Salama¹,

Azzam²,

Omar³

et al. 2012

AJMMS

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Use of HFOV is a common practice inside the neonatal intensive care unit (NICU). There is a concern regarding the level of noise produced by HFOV inside the NICU. Objective: To evaluate and define the noise intensity produced by the high-frequency, oscillatory ventilator sensormedics (HFOV) and the impact of the incubator on the transmission of noise in different places inside the NICU. Methods: Using a noise analyzer, the noise produced by the HFOV sensormedics was measured in two setups: inside a quiet room, and inside the NICU during working hours. Measurements were repeated 2 times: first, inside and outside the tested incubator, second, inside and outside the next incubator. No human newborns were involved in the study; instead, a mannequin was used to simulate a newborn. The noise analyzer was placed next to mannequin mouth while inside the incubator and midway between the mannequin and the ventilator while measurements were taken outside the incubator. Each measurement was recorded against different HFOV ▲P and different frequency settings. Each measurement set lasted five minutes, where the highest and lowest readings were recorded every minute, and the average value of noise intensity was calculated.

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Quality improvement of doctors' shift-change handover in neuro-critical care

Lyons

Standley

Gupta

2010

BMJ Quality & Safety

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Background Clinical handover is a necessary process for the continuation of safe patient care; however, deficiencies in the handover process can introduce error. While the number of handover studies increases, few have validated implemented improvements with repeated audit. Objective To improve the morning handover round on a busy critical care unit and assess sustainability of improvement through repeated audit. Design/Methods A quality improvement process based on prospective observational assessment of the doctor's shift-change handover was carried out, assessing the content of clinical information and effects of distractions, location and timing. The effect of a training session for the junior doctors with the introduction of a standardised handover protocol was assessed. Results The content of clinical information improved after the training session with introduction of a standardised protocol, but returned to baseline with a new cohort of untrained doctors. Distractions were associated with increased handover times for individual patients and for total handover time. Overall, handover time was shortest in the coffee room compared with ward and lecture theatre handovers. Individual patient handover time was positively correlated with clinical content scores. Four indices of critical illness all positively correlated with increased handover time. Conclusions Early specific training is vital for quality clinical handover. Distractions during handover cause inefficiency and can adversely affect information transfer. Changing handover location according to local environment can yield improved efficiency, structure and ease of management. Adequate time must be allocated for clinical handover especially when dealing with very sick and complex patients.Clinical handover between shift changes is a necessary process to ensure seamless continuity of patient care. However, deficiencies in the handover process can introduce error. The accurate transfer of a necessary amount of clinical information to allow the continuation of safe care and, in addition, bring fresh intelligence to clinical problems, requires an efficient, clear and comprehensive system of communication.Despite awareness that handover systems were inadequate as long ago as 1996 in the UK, 1 it has taken several years for action to be taken, prompting the production of guidelines for handover. 2Despite the large number of handover studies conducted in the past two decades ( We wished to improve the morning handover round on our 21-bed Neurosciences Critical Care Unit (NCCU), a busy unit with a bed occupancy rate of approximately 90%, caring for neurosurgical/neurology and general patients requiring intensive care. Our specific aim was to improve the quality of the whole process. We felt that a goodquality handover would use the most appropriate setting, where the environment enhanced information transfer in addition to maximising the time utilised so that pertinent and complete clinical information was presented and discussed without unnecessary ...

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Noise in the Pediatric Intensive Care Unit

Cited by 3 publications

References 71 publications

Noise in the postanaesthesia care unit

Noise in the postanaesthesia care unit

The Impact of Incubators on Noise Transmission Produced by High-Frequency Oscillatory Ventilator Inside the Neonatal Intensive Care Unit

Quality improvement of doctors' shift-change handover in neuro-critical care

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