Reducing noise at night in critical care
Creators: name: Girgis, Diana
Publisher: name: No Publisher Supplied
Year: 2021

description: Purpose of the Project: Noise in hospital settings serves as a significant dilemma for both patients and healthcare personnel. A number of evidence-based studies have shown that excessive noise contributes to a variety of negative complications that affect patients and staff members physically and cognitively. In addition, research studies revealed that various noise reduction campaigns in hospitals have been ineffective. This study aimed to reduce noise level in the critical care units to meet the recommendations according to the World Health Organization (WHO) guidelines, achieve improved patient satisfaction scores, and raise awareness to hospital employees of the direct impact one has on the patients’ outcomes.Methodology: The quality improvement study was conducted in 8 weeks with multiple phases while utilizing a quantitative approach, pre- and post-design, that assessed two factors: the HCAHPS scores and actual decibel level measurements from the critical care unit of a level II trauma hospital. HCAHPS scores are derived from the patient’s response on a post hospital stay survey regarding their stay, hospital environment, treatment received, and plan of care. The HCAHPS scores are publicly reported for everyone to see which can potentially impact the hospital’s reputation. In addition, the government uses the survey to provide financial incentives and disincentives to hospitals. To ensure adequate completion of the project, it was categorized into multiple phases. Phase one included pre-audit noise levels of the two units for 48 hours. Phase two was a retrospective review of HCAHPS scores for the two studied units from the previous quarter (April – June 2020) and was compared to the (October - December 2020) quarter. Phase three provided a learning module for staff members via the institution’s online system. Phase four of the project displayed visual aids throughout the units to expand awareness of the importance of noise control beyond the education from the campaign. The fifth and final phase was a post-audit noise level measurement for 48 hours and compared the results to the pre-audit levels and. The non-parametric test, Mann Whitney U, was used to determine differences by location.Results: The results were divided into four groups: ICU (high-side), ICU (low-side), CCU (high-side), and CCU (low-side), then compared to pre-and post-intervention months, October versus November. The high side of ICU had an average dB level of 54.154 before the noise reduction campaign however the November audit revealed the noise levels increased to an average of 58.439dB (Z = -27.395, p &lt; .0001). ICU (low) was noted to have a decrease in noise despite it being the “Covid” unit, with an average of 56.292dB preintervention compared to the postintervention average of 55.713dB (Z = -5.486, p &lt; .0001). The CCU high and low side had a statistical significance in noise reduction that was evident by the comparable averages of the high side averages of 64.312dB to 59.075dBs (Z = -34.479, p &lt; .0001). The low side of CCU also revealed a decrease in levels based on an average of 52.639 to November’s average of 50.409dB (Z = 19.805, p &lt; .0001). Meanwhile, the HCAHPS scores regarding hospital noise during the preintervention and postintervention were the same, however, the same sizes of the surveys were considerably small. In the month of December, the HCAHPS scores improved to 60%, surpassing the NJ hospitals benchmark.Implications for Practice: Sleep deprivation can have destructive repercussions to patients suffering from acute illnesses. All staff members have a key role in creating a healing milieu by making minor adjustments to tailor the patient level of care based on acuity and personalized treatment of plan.