1
|
Adams C, Walsan R, McDonnell R, Schembri A. As loud as a construction site: Noise levels in the emergency department. Australas Emerg Care 2024; 27:26-29. [PMID: 37532590 DOI: 10.1016/j.auec.2023.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND The Emergency Department (ED), while being an integral part of healthcare systems, frequently experiences noise levels surpassing the World Health Organization's recommended thresholds. These excessive noise levels could considerably compromise the safety and wellbeing of both patients and staff. METHODS To evaluate noise levels throughout the ED environment, this study utilized dosimeters to measure noise levels over a 24-hour period in six distinct locations, including the ED Waiting Room and Treatment areas. RESULTS The study found that noise exceeded the WHO recommendations in all six areas of the ED for the entire 24-hour period. Peak noise levels were recorded up to 102.8 dB, which is as loud as noise levels at a construction site. The ED Waiting Room exhibited high peak and average noise levels, indicating the urgent need for quality improvement efforts. These findings align with the results of previous research, thereby suggesting that noise levels in the ED have remained problematic for more than a decade. CONCLUSION The findings of this study underscore the importance of addressing excessive noise levels in the ED to create a safe and therapeutic hospital environment for both patients and staff. Healthcare organizations must implement proactive measures to address excessive noise levels in the ED.
Collapse
Affiliation(s)
- Corey Adams
- Australian Institute of Health Innovation (AIHI), Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW 2113, Australia.
| | - Ramya Walsan
- Australian Institute of Health Innovation (AIHI), Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW 2113, Australia
| | - Rebecca McDonnell
- Australian Institute of Health Innovation (AIHI), Macquarie University, 75 Talavera Rd, North Ryde, Sydney, NSW 2113, Australia
| | - Anthony Schembri
- St Vincent's Health Network, Sydney, 390 Victoria St, Darlinghurst, NSW 2010, Australia
| |
Collapse
|
2
|
Taskin O, Disel NR, Yilmaz M. Amidst the clamor: Effects of emergency department noise on Physicians' health and attention. Am J Emerg Med 2024; 76:87-92. [PMID: 38006637 DOI: 10.1016/j.ajem.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/27/2023] [Accepted: 11/07/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVE This study aims to assess effects of noise on physicians' stress levels and attention capacities within an emergency department. METHODS In this prospective cross-sectional study, 15 physicians from a state hospital emergency department with 300,000 annual visits provided demographics, work factors, and physiologic data. Attention was evaluated through smartphone-based Stroop tests, while noise and heart rates were monitored via smartwatches. RESULTS Median physician age was 26, with 16 months' emergency department experience. Average sound intensity was 68.80 dB. Despite noise, physicians in green/yellow areas showed increased Stroop scores (p = 0.002). Heart rate responses correlated with noise changes. End-of-shift surveys highlighted physicians' adaptability and resilience to high noise levels. CONCLUSION Noisy emergency departments pose health risks to physicians, but noise-related stress did not significantly affect attention, beneficial for patient care.
Collapse
Affiliation(s)
- Omer Taskin
- Emergency Service, Yuregir State Hospital, Adana, Turkey.
| | - Nezihat Rana Disel
- Department of Emergency Medicine, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Mustafa Yilmaz
- Department of Emergency Medicine, Faculty of Medicine, Firat University, Elazig, Turkey
| |
Collapse
|
3
|
Dickson VV, Blustein J, Weinstein B, Goldfeld K, Radcliffe K, Burlingame M, Grudzen CR, Sherman SE, Smilowitz J, Chodosh J. Providing Hearing Assistance to Veterans in the Emergency Department: A Qualitative Study. J Emerg Nurs 2022; 48:266-277. [PMID: 35172928 DOI: 10.1016/j.jen.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Effective communication is essential to good health care, and hearing loss disrupts patient-provider communication. For the more than 2 million veterans with severe hearing loss, communication is particularly challenging in noisy health care environments such as emergency departments. The purpose of this qualitative study was to describe patient and provider perspectives of feasibility and potential benefit of providing a hearing assistance device, a personal amplifier, during visits to an emergency department in an urban setting affiliated with the Department of Veterans Affairs. METHODS This qualitative descriptive study was conducted in parallel with a randomized controlled study. We completed a semistructured interview with 11 veterans and 10 health care providers to elicit their previous experiences with patient-provider communication in the ED setting and their perspectives on hearing screening and using the personal amplifier in the emergency department. Interview data were analyzed using content analysis and Atlas.ti V8.4 software (Scientific Software Development GmbH, Berlin, Germany). RESULTS The veteran sample (n = 11) had a mean age of 80.3 years (SD = 10.2). The provider sample included 7 nurses and 3 physicians. In the ED setting, hearing loss disrupts patient-provider communication. Screening for hearing loss in the emergency department was feasible except in urgent/emergent cases. The use of the personal amplifier made communication more effective and less effortful for both veterans and providers. DISCUSSION Providing the personal amplifier improved the ED experience for veterans and offers a promising intervention that could improve health care quality and safety for ED patient populations.
Collapse
|
4
|
Carey B, Dell CA, Stempien J, Tupper S, Rohr B, Carr E, Cruz M, Acoose S, Butt P, Broberg L, Collard L, Fele-Slaferek L, Fornssler C, Goodridge D, Gunderson J, McKenzie H, Rubin J, Shand J, Smith J, Trask J, Ukrainetz K, Meier S. Outcomes of a controlled trial with visiting therapy dog teams on pain in adults in an emergency department. PLoS One 2022; 17:e0262599. [PMID: 35263346 PMCID: PMC9064456 DOI: 10.1371/journal.pone.0262599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 11/13/2021] [Indexed: 01/15/2023] Open
Abstract
CONTEXT Pain is a primary reason individuals attend an Emergency Department (ED), and its management is a concern. OBJECTIVES Change in symptoms and physiologic variables at 3 time points pre-post a ten-minute St. John Ambulance therapy dog team visit compared to no visit in ED patients who experienced pain. DESIGN, SETTING AND PARTICIPANTS Using a controlled clinical trial design, pain, anxiety, depression and well-being were measured with the Edmonton Symptom Assessment System (revised version) (ESAS-r) 11-point rating scales before, immediately after, and 20 minutes post- therapy dog team visit with Royal University Hospital ED patients participating in the study (n = 97). Blood pressure and heart rate were recorded at the time points. Control data was gathered twice (30 minutes apart) for comparison (n = 101). There were no group differences in age, gender or ethnicity among the control and intervention groups (respectively mean age 59.5/57.2, ethnicity 77.2% Caucasian/87.6%, female 43.6% /39.2%, male 56.4%/60.8%,). INTERVENTION 10 minute therapy dog team visit in addition to usual care. MAIN OUTCOME MEASURES Change in reported pain from pre and post therapy dog team visit and comparison with a control group. RESULTS A two-way ANOVA was conducted to compare group effects. Significant pre- post-intervention differences were noted in pain for the intervention (mean changeint. = -0.9, SD = 2.05, p = .004, 95% confidence interval [CI] = [0.42, 1.32], ηp2 = 04) but not the control group. Anxiety (mean changeint. = -1.13, SD = 2.80, p = .005, 95% CI = [0.56, 1.64], ηp2 = .04), depression (mean changeint. = -0.72, SD = 1.71, p = .002, 95% CI = [0.39, 1.11], ηp2 = .047), and well-being ratings (mean changeint. = -0.87, SD = 1.84, p < .001, 95% CI = [0.49, 1.25], ηp2 = .07) similarly improved for the intervention group only. There were no pre-post intervention differences in blood pressure or heart rate for either group. Strong responders to the intervention (i.e. >50% reduction) were observed for pain (43%), anxiety (48%), depression (46%), and well-being (41%). CONCLUSIONS Clinically significant changes in pain as well as significant changes in anxiety, depression and well-being were observed in the therapy dog intervention compared to control. The findings of this novel study contribute important knowledge towards the potential value of ED therapy dogs to affect patients' experience of pain, and related measures of anxiety, depression and well-being. TRIAL REGISTRATION This controlled clinical trial is registered with ClinicalTrials.gov, registration number NCT04727749.
Collapse
Affiliation(s)
- Ben Carey
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Colleen Anne Dell
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
- * E-mail:
| | - James Stempien
- College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Susan Tupper
- Quality, Safety & Standards, Saskatchewan Health Authority,
Saskatoon, Saskatchewan, Canada
| | - Betty Rohr
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Eloise Carr
- Faculty of Nursing University of Calgary, Calgary, Alberta,
Canada
| | - Maria Cruz
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Sharon Acoose
- School of Indigenous Social Work, First Nations University of Canada,
Saskatoon, Saskatchewan, Canada
| | - Peter Butt
- College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Lindsey Broberg
- College of Medicine, University of Saskatchewan, Saskatoon,
Canada
| | - Lisa Collard
- Emergency Services, Saskatchewan Health Authority, Saskatoon,
Saskatchewan, Canada
| | | | - Cathie Fornssler
- Saskatchewan Centre for Patient Oriented Research, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Donna Goodridge
- College of Nursing & Respirology, Critical Care and Sleep Medicine,
University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Janet Gunderson
- Saskatchewan Centre for Patient Oriented Research, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Holly McKenzie
- Department of Sociology, University of Saskatchewan, Saskatoon,
Canada
| | - Joe Rubin
- Veterinary Microbiology, University of Saskatchewan, Saskatoon,
Saskatchewan, Canada
| | - Jason Shand
- Clinical Analyst, Saskatchewan Health Authority, Saskatoon, Saskatchewan,
Canada
| | - Jane Smith
- St. John Ambulance, Saskatoon, Saskatchewan, Canada
| | - Jason Trask
- Emergency Services, Saskatchewan Health Authority, Saskatoon,
Saskatchewan, Canada
| | - Kerry Ukrainetz
- Saskatchewan Centre for Patient Oriented Research, University of
Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Simona Meier
- Clinical Research Professional Clinical Trial Support Unit, University of
Saskatchewan, Saskatoon, Canada
| |
Collapse
|
5
|
Swan L, Hullick C, Etherton-Beer C, Arendts G. Holistic approach to undifferentiated acute severe behavioural disturbance in older emergency department patients. Emerg Med Australas 2021; 33:1100-1105. [PMID: 34535981 DOI: 10.1111/1742-6723.13865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Lachlan Swan
- Department of Emergency Medicine, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Carolyn Hullick
- Department of Emergency Medicine, Hunter New England Health Service, Newcastle, New South Wales, Australia.,Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | | | - Glenn Arendts
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
6
|
Fatovich DM. The signal is clear: It's noisy in the emergency department. Emerg Med Australas 2020; 32:354-356. [PMID: 32067346 DOI: 10.1111/1742-6723.13483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022]
Abstract
EDs are noisy and the noise levels exceed regulatory recommendations. Noise distracts us during any task and can saturate our attentional demand and impair our thinking and decision-making. This is a systematic problem that is consistently ignored by accreditation bodies. Many of our patients are vulnerable to the adverse impact of noise including the elderly, people with mental health problems, migraine and those with sensory impairments. Our noise levels are equivalent to a noisy restaurant. When noise levels are reduced, staff report less stress and better work conditions. Noise is a patient safety issue, as excessive noise impairs good communication, which is essential for patient care. Good acoustic design and management is achievable, but needs to be explicitly assessed as a part of accreditation standards. This would promote wellness for both patients and staff.
Collapse
Affiliation(s)
- Daniel M Fatovich
- Department of Emergency Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
| |
Collapse
|
7
|
Abstract
Flow-induced noise is a significant concern for the design and operation of centrifugal pumps. The negative impacts of flow-induced noise on operating stability, human health and the environment have been shown in many cases. This paper presents a comprehensive review of the flow-induced noise study for centrifugal pumps to synthesize the current study status. First, the generation mechanism and propagation route of flow-induced noise are discussed. Then, three kinds of study methodologies, including the theoretical study of hydrodynamic noise, numerical simulation and experimental measurement study, are summarized. Subsequently, the application of the three study methodologies to the analysis of the distribution characteristics of flow-induced noise is analyzed from aspects of the noise source identification and comparison, the frequency response analysis, the directivity characteristics of sound field and the noise changing characteristics under various operating conditions. After that, the analysis of the noise optimization design of centrifugal pumps is summarized. Finally, based on previous study results, this paper puts forward the unsolved problems and implications for future study. In conclusion, the information collected in this review paper could guide further study of the flow-induced noise of centrifugal pumps.
Collapse
|
8
|
Chang BP. Can hospitalization be hazardous to your health? A nosocomial based stress model for hospitalization. Gen Hosp Psychiatry 2019; 60:83-89. [PMID: 31376645 PMCID: PMC6791742 DOI: 10.1016/j.genhosppsych.2019.07.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/17/2019] [Accepted: 07/25/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Hospitalization places patients at elevated risk for the development of "nosocomial" or hospital acquired complications, ranging from multidrug resistant infections to delirium and physical deconditioning. Adverse nosocomial psychological effects of hospitalization may also exist. This paper introduces a nosocomial based stress model, conceptualizing hospitalization as a unique period of biopsychosocial vulnerability, due to physiologic effects of acute illness and psychosocial variables of the hospital experience. METHOD A research synthesis and narrative review was performed to evaluate evidence supporting this model, integrating existing knowledge of the psychological and physiological effects of acute life threatening events, with known sequelae associated with hospitalization. RESULT Psychosocial factors during hospitalization may act as independent predictors of recovery following hospitalization, moderating variables impacting ongoing physiologic changes due to acute illness, and/or dynamic bidirectional elements, influencing medical and psychological outcomes in the near and long-term setting. CONCLUSION The Nosocomial Stress model provides a novel framework to understanding the biopsychosocial interactions between the psychological and physiologic processes associated with illness and hospitalization. Based on this model, a research agenda is proposed to assess the contributions of acute illness, the hospital experience, and their interactions on the recovery of patients following hospitalization.
Collapse
Affiliation(s)
- Bernard P Chang
- Department of Emergency Medicine, Columbia University Medical Center, New York, NY, United States of America.
| |
Collapse
|
9
|
Cho WH, Jeong CH, Chang JH, Lee SH, Park MK, Suh MW, Han JJ. Noise and Room Acoustic Conditions in a Tertiary Referral Hospital, Seoul National University Hospital. J Audiol Otol 2019; 23:76-82. [PMID: 30989997 PMCID: PMC6468283 DOI: 10.7874/jao.2018.00269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/17/2018] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. Materials and Methods Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. Results The A-weighted equivalent noise level, LAeq, ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. Conclusions At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.
Collapse
Affiliation(s)
- Wan-Ho Cho
- Division of Physical Metrology, Korea Research Institute of Standards and Science, Daejeon, Korea
| | - Cheol-Ho Jeong
- Acoustic Technology, Electrical Engineering Department, Technical University of Denmark, Lyngby, Denmark
| | - Ji-Ho Chang
- Division of Physical Metrology, Korea Research Institute of Standards and Science, Daejeon, Korea
| | - Seong-Hyun Lee
- Department of System Dynamics, Korea Institute of Machinery & Materials, Daejeon, Korea
| | - Moo Kyun Park
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| | - Myung-Whan Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| | - Jae Joon Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
10
|
Crawford KJ, Barnes LA, Peters TM, Falk J, Gehlbach BK. Identifying determinants of noise in a medical intensive care unit. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:810-817. [PMID: 30193088 PMCID: PMC6372309 DOI: 10.1080/15459624.2018.1515491] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 06/08/2023]
Abstract
Continuous and intermittent exposure to noise elevates stress, increases blood pressure, and disrupts sleep among patients in hospital intensive care units. The purpose of this study was to determine the effectiveness of a behavior-based intervention to reduce noise and to identify determinants of noise in a medical intensive care unit. Staff were trained for 6 weeks to reduce noise during their activities in an effort to keep noise levels below 55 dBA during the day and below 50 dBA at night. One-min noise levels were logged continuously in patient rooms 8 weeks before and after the intervention. Noise levels were compared by room position, occupancy status, and time of day. Noise levels from flagged days (>60 dBA for >10 hr) were correlated with activity logs. The intervention was ineffective, with noise frequently exceeding project goals during the day and night. Noise levels were higher in rooms with the oldest heating, ventilation, and air-conditioning system, even when patient rooms were unoccupied. Of the flagged days, the odds of noise over 60 dBA occurring was 5.3 dBA higher when high-flow respiratory support devices were in use compared to times with low-flow devices in use (OR = 5.3, 95% CI = 5.0-5.5). General sources, like the heating, ventilation, and air-conditioning system, contribute to high baseline noise and high-volume (>10 L/min) respiratory-support devices generate additional high noise (>60 dBA) in Intensive Care Unit patient rooms. This work suggests that engineering controls (e.g., ventilation changes or equipment shielding) may be more effective in reducing noise in hospital intensive care units than behavior modification alone.
Collapse
Affiliation(s)
- Kathryn J. Crawford
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa
| | - Lindsey A. Barnes
- Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, Carver College of Medicine, University of Iowa
| | - Thomas M. Peters
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa
| | - Jeffrey Falk
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa
| | - Brian K. Gehlbach
- Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, Carver College of Medicine, University of Iowa
| |
Collapse
|
11
|
Abstract
PURPOSE Noise levels remain high in clinical settings, which may result in stress and sleep disruption, and can lead to immunosuppression, delayed healing, confusion, disorientation, delusions, and increased length of hospital stay. The purpose of this quality improvement project was to assess effects of a multidisciplinary noise reduction program on a pediatric unit in an acute care hospital in a developing country. METHODS A quality improvement project was carried out over 15 months in a pediatric unit. A three-phase study was conducted where the first phase included obtaining patient satisfaction ratings and recording sound levels, the second phase included implementing a noise reduction program and designing a noise detector machine, and the third phase included obtaining patient satisfaction data and recording noise levels over a 1-year period. RESULTS There was a significant decrease in noise of 8 A-weighted decibels when comparing the values before and after implementing the quality improvement project at t = 6.44, p < 0.000. There was no significant difference in patient satisfaction ratings. CLINICAL IMPLICATIONS Noise in the pediatric unit exceeded recommended guidelines; however, decreasing the levels was possible and sustainable, which can improve the psychological and physiological wellbeing of hospitalized children.
Collapse
|
12
|
Baqar M, Arslan M, Abbasi SA, Ashraf U, Khalid A, Zahid H. Noise pollution in the hospital environment of a developing country: A case study of Lahore (Pakistan). ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2017; 73:367-374. [PMID: 28836912 DOI: 10.1080/19338244.2017.1371106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/20/2017] [Indexed: 06/07/2023]
Abstract
The present study investigates the noise pollution levels in public- and private-sector hospitals of Lahore. The noise pollution parameters were investigated from 20 public and 10 private hospitals. We observed that the equivalent continuous sound level (Leq) values varied significantly in different departments of the hospitals as well as at different times of the day. The public-sector hospitals had significantly higher noise pollution compared to the private-sector hospitals. The Wilcoxon Mann-Whitney two-sample rank-sum test revealed significant difference between noise levels in intensive care unit (ICU) during morning and in emergency, waiting area, intensive care unit (ICU), and reception during daytimes. However, no significant differences were found for any department during the evening. The Leq values were found to be higher than the international norms (WHO standards) for all hospitals, higher than USEPA for 29 hospitals and higher than local standards for 27 hospitals. Overall, significantly lower sound levels were always observed in private hospitals.
Collapse
Affiliation(s)
- Mujtaba Baqar
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
- b Sustainable Development Study Centre , Government College University , Lahore , Pakistan
| | - Muhammad Arslan
- c Geosciences Department , King Fahd University of Petroleum and Minerals , Dhahran , Saudi Arabia
- d Environmental Biotechnology Department, Helmholtz Center for Environmental Research , Leipzig , Germany
| | - Saddam A Abbasi
- e Department of Mathematics, Statistics and Physics , Qatar University , Doha , Qatar
| | - Uzma Ashraf
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
| | - Anam Khalid
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
| | - Hina Zahid
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
| |
Collapse
|
13
|
Iyendo TO. Sound as a supportive design intervention for improving health care experience in the clinical ecosystem: A qualitative study. Complement Ther Clin Pract 2017; 29:58-96. [PMID: 29122270 DOI: 10.1016/j.ctcp.2017.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/17/2017] [Accepted: 08/22/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE Most prior hospital noise research usually deals with sound in its noise facet and is based merely on sound level abatement, rather than as an informative or orientational element. This paper stimulates scientific research into the effect of sound interventions on physical and mental health care in the clinical environment. METHODS Data sources comprised relevant World Health Organization guidelines and the results of a literature search of ISI Web of Science, ProQuest Central, MEDLINE, PubMed, Scopus, JSTOR and Google Scholar. RESULTS Noise induces stress and impedes the recovery process. Pleasant natural sound intervention which includes singing birds, gentle wind and ocean waves, revealed benefits that contribute to perceived restoration of attention and stress recovery in patients and staff. CONCLUSIONS Clinicians should consider pleasant natural sounds perception as a low-risk non-pharmacological and unobtrusive intervention that should be implemented in their routine care for speedier recovery of patients undergoing medical procedures.
Collapse
|
14
|
Khaiwal R, Singh T, Tripathy JP, Mor S, Munjal S, Patro B, Panda N. Assessment of noise pollution in and around a sensitive zone in North India and its non-auditory impacts. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 566-567:981-987. [PMID: 27318606 DOI: 10.1016/j.scitotenv.2016.05.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 05/21/2023]
Abstract
Noise pollution in hospitals is recognized as a serious health hazard. Considering this, the current study aimed to map the noise pollution levels and to explore the self reported non-auditory effects of noise in a tertiary medical institute. The study was conducted in an 1800-bedded tertiary hospital where 27 sites (outdoor, indoor, road side and residential areas) were monitored for exposure to noise using Sound Level Meter for 24h. A detailed noise survey was also conducted around the sampling sites using a structured questionnaire to understand the opinion of the public regarding the impact of noise on their daily lives. The equivalent sound pressure level (Leq) was found higher than the permissible limits at all the sites both during daytime and night. The maximum equivalent sound pressure level (Lmax) during the day was observed higher (>80dB) at the emergency and around the main entrance of the hospital campus. Almost all the respondents (97%) regarded traffic as the major source of noise. About three-fourths (74%) reported irritation with loud noise whereas 40% of respondents reported headache due to noise. Less than one-third of respondents (29%) reported loss of sleep due to noise and 8% reported hypertension, which could be related to the disturbance caused due to noise. Noise levels in and around the hospital was well above the permissible standards. The recent Global Burden of Disease highlights the increasing risk of non communicable diseases. The non-auditory effects studied in the current work add to the risk factors associated with non communicable diseases. Hence, there is need to address the issue of noise pollution and associated health risks specially for vulnerable population.
Collapse
Affiliation(s)
- Ravindra Khaiwal
- School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh -160012, India.
| | - Tanbir Singh
- Department of Environment Studies, Panjab University, Chandigarh 160014, India
| | - Jaya Prasad Tripathy
- School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh -160012, India; International Union Against Tuberculosis and Lung Disease, The Union South East Asia Office, New Delhi 110016, India
| | - Suman Mor
- Department of Environment Studies, Panjab University, Chandigarh 160014, India; Center for Public Health, Panjab University, Chandigarh 160025, India
| | - Sanjay Munjal
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| | - Binod Patro
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, India
| | - Naresh Panda
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| |
Collapse
|
15
|
Iyendo TO. Exploring the effect of sound and music on health in hospital settings: A narrative review. Int J Nurs Stud 2016; 63:82-100. [PMID: 27611092 DOI: 10.1016/j.ijnurstu.2016.08.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 08/13/2016] [Accepted: 08/14/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sound in hospital space has traditionally been considered in negative terms as both intrusive and unwanted, and based mainly on sound levels. However, sound level is only one aspect of the soundscape. There is strong evidence that exploring the positive aspect of sound in a hospital context can evoke positive feelings in both patients and nurses. Music psychology studies have also shown that music intervention in health care can have a positive effect on patient's emotions and recuperating processes. In this way, hospital spaces have the potential to reduce anxiety and stress, and make patients feel comfortable and secure. This paper describes a review of the literature exploring sound perception and its effect on health care. DATA SOURCES AND REVIEW METHODS This review sorted the literature and main issues into themes concerning sound in health care spaces; sound, stress and health; positive soundscape; psychological perspective of music and emotion; music as a complementary medicine for improving health care; contradicting arguments concerning the use of music in health care; and implications for clinical practice. Using Web of Science, PubMed, Scopus, ProQuest Central, MEDLINE, and Google, a literature search on sound levels, sound sources and the impression of a soundscape was conducted. The review focused on the role and use of music on health care in clinical environments. In addition, other pertinent related materials in shaping the understanding of the field were retrieved, scanned and added into this review. RESULTS The result indicated that not all noises give a negative impression within healthcare soundscapes. Listening to soothing music was shown to reduce stress, blood pressure and post-operative trauma when compared to silence. Much of the sound conveys meaningful information that is positive for both patients and nurses, in terms of soft wind, bird twitter, and ocean sounds. CONCLUSIONS Music perception was demonstrated to bring about positive change in patient-reported outcomes such as eliciting positive emotion, and decreasing the levels of stressful conditions. Whilst sound holds both negative and positive aspects of the hospital ecosystem and may be stressful, it also possesses a soothing quality that induces positive feelings in patients. Conceptualizing the nature of sound in the hospital context as a soundscape, rather than merely noise can permit a subtler and socially useful understanding of the role of sound and music in the hospital setting, thereby creating a means for improving the hospital experience for patients and nurses.
Collapse
Affiliation(s)
- Timothy Onosahwo Iyendo
- Department of Architecture, Eastern Mediterranean University, Gazimağusa, North Cyprus, Via Mersin 10, Turkey.
| |
Collapse
|
16
|
Iyendo TO, Uwajeh PC, Ikenna ES. The therapeutic impacts of environmental design interventions on wellness in clinical settings: A narrative review. Complement Ther Clin Pract 2016; 24:174-88. [PMID: 27502819 DOI: 10.1016/j.ctcp.2016.06.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 06/24/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this review is to document the role of physical environmental factors in clinical environments and their impact on patients and staff wellness with a particular focus on physical and mental healthcare. METHODS Data sources comprised relevant English language articles and the results of literature search of ISI Web of Knowledge, PubMed, Scopus, ProQuest Central, MEDLINE, and Google. RESULTS Incorporating physical environmental factors into hospital design can facilitate better user satisfaction, efficiency and organisational outcomes. Many of the design interventions convey positive distractions for patients and staff, in terms of views of pleasant outside vistas, soothing sound, artwork and music. CONCLUSIONS Well-designed physical settings play an important role in the healing process of patients in health care facilities. The challenge then is to fully understand that role in the ecological context of health care. Other contributors are possible and should be explored in further research.
Collapse
Affiliation(s)
- Timothy Onosahwo Iyendo
- Department of Architecture, Eastern Mediterranean University, Gazimağusa, North Cyprus, Via Mersin 10, Turkey.
| | - Patrick Chukwuemeke Uwajeh
- Department of Architecture, Eastern Mediterranean University, Gazimağusa, North Cyprus, Via Mersin 10, Turkey
| | - Ezennia Stephen Ikenna
- Department of Architecture, Nnamdi Azikwe University Awka, Anambra State, PMB, 5025, Awka, Nigeria
| |
Collapse
|
17
|
Wang Z, Downs B, Farell A, Cook K, Hourihan P, McCreery S. Role of a service corridor in ICU noise control, staff stress, and staff satisfaction: environmental research of an academic medical center. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2016; 6:80-94. [PMID: 23817908 DOI: 10.1177/193758671300600307] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the role of a dedicated service corridor in intensive care unit (ICU) noise control and staff stress and satisfaction. BACKGROUND Shared corridors immediately adjacent to patient rooms are generally noisy due to a variety of activities, including service deliveries and pickups. The strategy of providing a dedicated service corridor is thought to reduce noise for patient care, but the extent to which it actually contributes to noise reduction in the patient care environment and in turn improves staff performance has not been previously documented. METHODS A before-and-after comparison was conducted in an adult cardiac ICU. The ICU was relocated from a traditional hospital environment to a new addition with a dedicated service corridor. A total of 118 nursing staff participated in the surveys regarding pre-move and post-move environmental comfort, stress, and satisfaction in the previous and new units. Acoustical measures of noise within the new ICU and a control environment of the previous unit were collected during four work days, along with on-site observations of corridor traffic. RESULTS Independent and paired sample t-tests of survey data showed that the perceived noise level was lower and staff reported less stress and more satisfaction in the new ICU (p < 0.01). Analyses of acoustical data confirmed that the new ICU was significantly quieter (p < 0.02). Observations revealed how the service corridor impacted patient care services and traffic. CONCLUSIONS The addition of a dedicated service corridor works in the new unit for improving noise control and staff stress and satisfaction. KEYWORDS Critical care/intensive care, noise, satisfaction, staff, work environment.
Collapse
Affiliation(s)
- Zhe Wang
- CORRESPONDING AUTHOR: Kimberly Cook, Senior Associate, Canon Design, 225 N. Michigan Ave., Suite 1100, Chicago, IL 60601; ; (312) 332-9600
| | | | | | | | | | | |
Collapse
|
18
|
Carvalhais C, Santos J, da Silva MV, Xavier A. Is There Sufficient Training of Health Care Staff on Noise Reduction in Neonatal Intensive Care Units? a Pilot Study From Neonoise Project. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2015; 78:897-903. [PMID: 26167755 DOI: 10.1080/15287394.2015.1051204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Evidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement, and evaluate the effectiveness of a training program (TP) on noise reduction in a neonatal intensive care unit (NICU) by comparing the noise levels before and after the implementation of the program. In total, 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and locations of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly, following implementation of the training program, noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However, a significant difference was found for Lp,Cpeak, before and after training staff, suggesting greater care by health care professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.
Collapse
Affiliation(s)
- Carlos Carvalhais
- a Environmental Health Department and Research Centre on Health and Environment (CISA) , School of Allied Health Technologies of Polytechnic Institute of Porto (ESTSP.IPP) , Vila Nova de Gaia , Portugal
| | | | | | | |
Collapse
|
19
|
Welch SJ, Cheung DS, Apker J, Patterson ES. Strategies for Improving Communication in the Emergency Department: Mediums and Messages in a Noisy Environment. Jt Comm J Qual Patient Saf 2013; 39:279-86. [DOI: 10.1016/s1553-7250(13)39039-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|