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What’s all that noise—Improving the hospital soundscape

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Abstract

Hospital noise levels regularly exceed those recommended by the World Health Organization (WHO). It is uncertain whether high noise levels have adverse effects on patient health. High levels of noise increase patient sleep loss, anxiety levels, length of hospital stay, and morbidity rates. Staff conversation and auditory medical alarms are amongst the leading noise producing stimuli, with combinations of stimuli accounting for much of the high noise levels. The Hospital Consumer Assessment of Healthcare Providers and Systems survey shows a slight improvement in overall hospital noise levels in the United States, indicating a minor reduction in noise levels. Alarm ambiguity, alarm masking and inefficient alarm design contributes to a large portion of sounds that exceed the environmental noise level in the hospital. Improving the hospital soundscape can begin by training staff in noise reduction, enforcing noise reduction programs, reworking alarm design and encouraging research to evaluate the relative effects of noise producing stimuli on the hospital soundscape.

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References

  1. Berglund B, Lindvall T, Schwela DH, World Health Organization Occupational and Environmental Health Team. Guidelines for community noise. Geneva: World Health Organization; 1999.

    Google Scholar 

  2. Hui X, Jian K, Mills GH. Clinical review: the impact of noise on patients’ sleep and the effectiveness of noise reduction strategies in intensive care units. Crit Care. 2009;13(2):208. https://doi.org/10.1186/cc7154.

    Article  Google Scholar 

  3. Elliott R, Raib T, McKinley S. Factors affecting sleep in the critically ill: an observational study. J Crit Care. 2014;29:859–63. https://doi.org/10.1016/j.jcrc.2014.05.015.

    Article  PubMed  Google Scholar 

  4. Grossman MN, Anderson SL, Worku A, Marsack W, Desai N, Tuvilleja A, Ramos J, Francisco MA, Lafond C, Balachandran JS, Mokhlesi B. Awakenings? Patient and hospital staff perceptions of nighttime disruptions and their effect on patient sleep. J Clin Sleep Med. 2017;13(2):301–6. https://doi.org/10.5664/jcsm.6468.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Waye KP, Elmenhorst EM, Croya I, Pedersen E. Improvement of intensive care unit sound environment and analyses of consequences on sleep. Sleep Med. 2013;14:1334–40. https://doi.org/10.1016/j.sleep.2013.07.011.

    Article  Google Scholar 

  6. DeKeyser F. Psychoneuroimmunology in critically Ill patients. AACN Clin Issues. 2003;14(1):25–32.

    Article  PubMed  Google Scholar 

  7. Adatia S, Law S, Haggerty J. Room for improvement: noise on a maternity ward. BMC Health Serv Res. 2014;14:604. https://doi.org/10.1186/s12913-014-0604-3.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kahn DM, Cook TE, Carlisle CC, Nelson DL, Kramer NR, Millman RP. Identification and modification of environmental noise in an ICU setting. Chest 1998;114(2):535–40. https://doi.org/10.1378/chest.114.2.535.

    Article  CAS  PubMed  Google Scholar 

  9. Johansson L, Bergbom I, Persson Waye K, Ryherd E, Lindahl B. The sound environment in an ICU patient room—a content analysis of sound levels and patient experiences. Intensive Crit Care Nurs. 2012;28(5):269–79. https://doi.org/10.1016/j.iccn.2012.03.004.

    Article  PubMed  Google Scholar 

  10. Akansel N, Kaymakçi Ş. Effects of intensive care unit noise on patients: a study on coronary artery bypass graft surgery patients. J Clin Nurs. 2008;17(12):1581–90. https://doi.org/10.1111/j.1365-2702.2007.02144.x.

    Article  PubMed  Google Scholar 

  11. MacKenzie DJ, Galbrun L. Noise levels and noise sources in acute care hospital wards. Build Serv Eng Res Technol. 2007;28(2):117–31.

    Article  Google Scholar 

  12. Stanchina ML, Abu-Hijleh M, Chaudhry BK, Carlisle CC, Millman RP. The influence of white noise on sleep in subjects exposed to ICU noise. Sleep Med. 2005;6(5):423–8. https://doi.org/10.1016/j.sleep.2004.12.004.

    Article  PubMed  Google Scholar 

  13. Tilz RR, Lin T, Eckardt L, Deneke T, Andresen D, Wieneke H, Brachmann J, Kääb S, Chun KRJ, Münkler P, Lewalter T, Hochadel M, Senges J, Kuck KH. Ablation outcomes and predictors of mortality following catheter ablation for ventricular tachycardia: data from the German Multicenter Ablation Registry. J Am Heart Assoc. 2018;7(6):e007045. https://doi.org/10.1161/JAHA.117.007045.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Edworthy J, Hellier E. Fewer but better auditory alarms will improve patient safety. BMJ Qual Saf. 2005;14:212–5.

    Article  CAS  Google Scholar 

  15. Edworthy J, Loxley S, Dennis I. Improving auditory warning design: relationship between warning sound parameters and perceived urgency. Hum Factors: J Hum Factors Ergon Soc. 1991;33(2):205–31.

    Article  CAS  Google Scholar 

  16. Ding Q, Redeker NS, Pisani MA, Yaggi HK, Knauert MP. Factors influencing patients’ sleep in the intensive care unit: patient and clinical staff perceptions. Am J Crit Care. 2017;26(4):278–86. https://doi.org/10.4037/ajcc2017333

    Article  PubMed  PubMed Central  Google Scholar 

  17. Maidl CA, Leske JS, Garcia AE. The influence of “quiet time” for patients in critical care. Clin Nurs Res. 2013;23:544–59. https://doi.org/10.1177/1054773813493000.

    Article  PubMed  Google Scholar 

  18. Centers for Medicare & Medicaid Services. Summary of HCAHPS survey results. https://hcahpsonline.org (2017). Accessed Dec 2017.

  19. Centers for Medicare & Medicaid Services. Summary of HCAHPS survey results. https://hcahpsonline.org (2013). Accessed Dec 2013.

  20. Centers for Medicare & Medicaid Services. Summary of HCAHPS Survey Results. https://hcahpsonline.org (2008). Accessed Dec 2008.

  21. Konkani A, Oakley B, Penprase B. Reducing hospital ICU noise: a behavior-based approach. J Healthc Eng. 2014;5(2):229–46.

    Article  PubMed  Google Scholar 

  22. Chawla S, Barach P, Dwaihy M, Kamat D, Shankaran S, Panaitescu B, Wang B, Natarajan G. A targeted noise reduction observational study for reducing noise in a neonatal intensive unit. J Perinatol. 2017;37:1060–4.

    Article  CAS  PubMed  Google Scholar 

  23. Kristensen MS, Edworthy J, Özcan Vieira E, Denham S. Alarm fatigue in the perception of medical soundscapes. In: EuroNoise 2015. pp. 745–750.

  24. Edworthy J. Medical audible alarms: a review. J Am Med Inform Assoc. 2013;20(3):584–9. https://doi.org/10.1136/amiajnl-2012-001061.

    Article  PubMed  Google Scholar 

  25. Bitan Y, O’Connor MF. Correlating data from different sensors to increase the positive predictive value of alarms: an empiric assessment. F1000Res 2012;1:45. https://doi.org/10.12688/f1000research.1-45.v1.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Imhoff M, Kuhls S, Gather U, Fried R. Smart alarms from medical devices in the OR and ICU. Best Pract Res Clin Anaesthesiol. 2009;23(1):39–50.

    Article  PubMed  Google Scholar 

  27. Hasanain B, Boyd AD, Edworthy J, Bolton ML. A formal approach to discovering simultaneous additive masking between auditory medical alarms. Appl Ergon. 2017;58:500–14.

    Article  PubMed  Google Scholar 

  28. Edworthy J, Hellier E. Alarms and human behaviour: implications for medical alarms. Br J Anaesth. 2006;97(1):12–7.

    Article  CAS  PubMed  Google Scholar 

  29. Edworthy J, Reid S, McDougall S, Edworthy J, Hall S, Bennett D, Khan J, Pye E. The recognizability and localizability of auditory alarms: setting global medical device standards. Hum Factors: J Hum Factors Ergon Soc. 2017;59(7):1108–27.

    Article  Google Scholar 

  30. Sanderson P, Wee A, Seah E, Lacherez P. Auditory alarms, medical standards, and urgency. Paper presented at the 12th International Conference on Auditory Display, London; (2006).

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Correspondence to Anthony J. Oleksy.

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None of the authors of this paper has a financial or personal relationship with other people or organizations that could inappropriately influence or bias the content of the paper. It is to specifically state that there are no conflicts of interest.

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Oleksy, A.J., Schlesinger, J.J. What’s all that noise—Improving the hospital soundscape. J Clin Monit Comput 33, 557–562 (2019). https://doi.org/10.1007/s10877-018-0215-3

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  • DOI: https://doi.org/10.1007/s10877-018-0215-3

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