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Adams C, Harrison R, Schembri A, Junge M, Walpola R. The silent threat: investigating sleep disturbances in hospitalized patients. Int J Qual Health Care 2024; 36:mzae042. [PMID: 38727537 PMCID: PMC11107945 DOI: 10.1093/intqhc/mzae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024] Open
Abstract
Sleep disruptions in the hospital setting can have adverse effects on patient safety and well-being, leading to complications like delirium and prolonged recovery. This study aimed to comprehensively assess the factors influencing sleep disturbances in hospital wards, with a comparison of the sleep quality of patients staying in single rooms to those in shared rooms. A mixed-methods approach was used to examine patient-reported sleep quality and sleep disruption factors, in conjunction with objective noise measurements, across seven inpatient wards at an acute tertiary public hospital in Sydney, Australia. The most disruptive factor to sleep in the hospital was noise, ranked as 'very disruptive' by 20% of patients, followed by acute health conditions (11%) and nursing interventions (10%). Patients in shared rooms experienced the most disturbed sleep, with 51% reporting 'poor' or 'very poor' sleep quality. In contrast, only 17% of the patients in single rooms reported the same. Notably, sound levels in shared rooms surpassed 100 dB, highlighting the potential for significant sleep disturbances in shared patient accommodation settings. The results of this study provide a comprehensive overview of the sleep-related challenges faced by patients in hospital, particularly those staying in shared rooms. The insights from this study offer guidance for targeted healthcare improvements to minimize disruptions and enhance the quality of sleep for hospitalized patients.
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Affiliation(s)
- Corey Adams
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, NSW 2113, Australia
| | - Reema Harrison
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, NSW 2113, Australia
| | | | | | - Ramesh Walpola
- School of Health Sciences, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
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Huang M, Yan Y, Wang Y, Sun X. Noise Reduction Nursing in a Noisy Ward Environment Effectively Improves the Mental and Physical Health of Patients Who Underwent Intracranial Aneurysm Embolization: A Retrospective Study. Noise Health 2024; 26:158-164. [PMID: 38904817 DOI: 10.4103/nah.nah_36_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/26/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVE This study aims to investigate the impact of noise reduction nursing in ward on patients who underwent intracranial aneurysm embolization. METHODS Between April 2020 and March 2021, Funan County People's Hospital implemented standard nursing care for patients who underwent intracranial aneurysm embolization, comprising 55 patients admitted during this period, constituting the control group. Subsequently, from April 2021 to March 2022, the hospital introduced noise reduction nursing measures in wards. A total of 65 patients admitted during this period were included in the study group. Data on noise levels, emotional states, and sleep statuses were collected from both groups. The comprehensive impact of noise reduction nursing on the mental and physical health of patients who underwent intracranial aneurysm embolization was evaluated. RESULTS Before propensity score matching (PSM), significant differences were observed in age and intracranial aneurysm diameter between the two groups (P < 0.05). However, following PSM, a total of 102 patients were included in the analysis, and no significant differences in baseline data were observed between the two groups (P > 0.05). The noise level in the study group's ward was significantly lower than that in the control group (P < 0.05). In addition, post-management, the study group exhibited lower Self-rating Anxiety Scale scores and total scores of Pittsburgh Sleep Quality Index compared with the control group. Moreover, the Glasgow Coma Scale score was higher in the study group, demonstrating statistical significance (P < 0.05). CONCLUSION The implementation of noise reduction nursing in wards effectively controls ward noise levels and improves negative mood and sleep quality among patients who underwent intracranial aneurysm embolization. These findings indicate that noise reduction nursing facilitates postoperative rehabilitation and enhances patient outcomes.
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Affiliation(s)
- Mei Huang
- Department of Neurosurgery, Funan County People's Hospital, Fuyang, Anhui, 236300, China
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Zhang L, Cheng W, Zhao M, Tang H. Effect of Acoustic Environment in Wards on Postoperative Rehabilitation in Patients with Oral Cancer: A Retrospective Study. Noise Health 2024; 26:148-152. [PMID: 38904815 DOI: 10.4103/nah.nah_34_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/11/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVE The increase in patient flow, replacement of medical equipment, and variations in surrounding environments induce increasingly serious acoustic environment problems in hospitals. This study aims to provide additional bases for the formulation of subsequent management plans in clinical practice by analyzing the influence of the acoustic environment in wards and the postoperative rehabilitation effect among patients with oral cancer. METHODS The medical records of 210 patients with oral cancer undergoing surgical treatment in Jinan Stomatological Hospital from February 2020 to October 2022 were selected for retrospective analysis. Patients with the acoustic environment in wards >55 and ≤55 dB were classified as groups A and B, respectively, according to the acoustic environment in wards. The effects of the acoustic environment in wards on postoperative blood pressure, blood viscosity, and blood glucose fluctuation (BGF) were observed to further analyze their relationship. RESULTS No significant difference was observed in indices such as preoperative systolic pressure (SP), diastolic pressure (DP), cardiac output (CO), postoperative CO, total cholesterol, and low- and high-density lipoproteins between the two groups (P > 0.05). The SP, DP, whole blood low-shear viscosity (WBLSV), whole blood middle-shear viscosity (WBMSV), whole blood high-shear viscosity (WBHSV), and BGF in group B were significantly lower than group A (P < 0.05). Correlation results showed that the total mean value of the acoustic environment in wards was positively correlated with SP, DP, WBLSV, WBMSV, WBHSV, and BGF (P < 0.05). CONCLUSION The high acoustic environment in wards is significantly positively correlated with postoperative blood pressure, blood viscosity, and BGF in patients with oral cancer. The hospital should focus on and strengthen the management of the acoustic environment in wards, providing additional schemes to promote the postoperative recovery of patients with oral cancer.
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Affiliation(s)
- Lu Zhang
- Department of Periodontology, Tianjin Medical University Stomatological Hospital, Tianjin 300070, China
| | - Wei Cheng
- Special Diagnosis Department, Jinan Stomatological Hospital, Jinan 250000, Shandong, China
| | - Mingzhe Zhao
- Department of Prosthodontics, Jinan Stomatological Hospital, Jinan 250000, Shandong, China
| | - Hanying Tang
- Department of Prosthodontics, Jinan Stomatological Hospital, Jinan 250000, Shandong, China
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Alves M, Monteiro E, Nogueira M, Távora C, Sarmento F, Marques Macedo I, Gomez N, Fonseca T, Nunes Silva G. Night-Time Noise and Sleep Quality in an Internal Medicine Ward in Portugal: An Observational Study. ACTA MEDICA PORT 2024; 37:119-125. [PMID: 36913950 DOI: 10.20344/amp.19042] [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: 09/05/2022] [Accepted: 01/12/2023] [Indexed: 03/15/2023]
Abstract
INTRODUCTION Hospitals should provide a quiet environment to promote patient healing and well-being. However, published data indicates that World Health Organization's guidelines are frequently not met. The aim of the present study was to quantify night-time noise levels in an internal medicine ward and evaluate sleep quality, as well as the use of sedative drugs. MATERIAL AND METHODS Prospective observational study in an acute internal medicine ward. Between April 2021 and January 2022, on random days, noise was recorded using a smartphone app (Apple® iOS, Decibel X). Night-time noise was recorded from 10 p.m. to 8 a.m. During the same period, hospitalized patients were invited to respond to a questionnaire regarding their sleep quality. RESULTS A total of 59 nights were recorded. The average noise level recorded was 55 dB with a minimum of 30 dB and a maximum of 97 dB. Fifty-four patients were included. An intermediate score for night-time sleep quality (35.45 out of 60) and noise perception (5.26 out of 10) was reported. The main reasons for poor sleep were related to the presence of other patients (new admission, acute decompensation, delirium, and snoring), followed by equipment, staff noise and surrounding light. Nineteen patients (35%) were previous users of sedatives, and during hospitalization 41 patients (76%) were prescribed sedatives. CONCLUSION The noise levels detected in the internal medicine ward were higher than the levels recommended by the World Health Organization. Most patients were prescribed sedatives during hospitalization.
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Affiliation(s)
- Mariana Alves
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon; Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
| | - Emília Monteiro
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon. Portugal
| | - Margarida Nogueira
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon. Portugal
| | - Catarina Távora
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon. Portugal
| | - Francisca Sarmento
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon. Portugal
| | - Inês Marques Macedo
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon. Portugal
| | - Nayive Gomez
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon; Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
| | - Teresa Fonseca
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon; Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
| | - Glória Nunes Silva
- Serviço de Medicina III. Hospital Pulido Valente. Centro Hospitalar e Universitário de Lisboa Norte. Lisbon; Faculdade de Medicina. Universidade de Lisboa. Lisbon. Portugal
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Xue Y, Lu B, He Y, Lu M. Evaluation on the Effect of Ward-Noise Reduction Management Combined with Monitoring-Training-Planning Management Mode in Hospitalized Patients with Heart Failure. Noise Health 2024; 26:30-36. [PMID: 38570308 PMCID: PMC11141696 DOI: 10.4103/nah.nah_80_23] [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: 09/06/2023] [Revised: 01/04/2023] [Accepted: 01/29/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Noise from medical institutions such as hospitals usually exceeds the level recommended by the World Health Organization. This study aimed to explore the application effect of ward-noise reduction management combined with monitoring-training-planning (MTP) management mode in hospitalized patients with heart failure. MATERIALS AND METHODS Among the 168 research objects, 55 patients with heart failure receiving ward-noise reduction management combined with MTP management mode from April 2022 to March 2023 were included in group A, 52 patients with heart failure who underwent MTP management mode from March 2021 to March 2022 were selected as group B, and 61 patients who underwent routine management measures from March 2020 to February 2021 served as the control group. The vital signs, Self-rating Anxiety Scale (SAS) scores, Self-rating Depression Scale (SDS) scores, physical function indices, sleep quality score, and satisfaction degree of patients in the three groups were compared before and after management. RESULTS After 1 month of management, group A had lower heart rate, diastolic blood pressure, systolic blood pressure, and respiratory rate compared to group B and the control group (P < 0.001). The SAS score, SDS score, and Pittsburgh Sleep Quality Index score after management in group A were lower than those in group B and the control group (P < 0.001). Group A had a higher 6-Minute Walk Distance than group B and the control group (P < 0.001). Group A had a higher satisfaction degree after management compared to group B (P < 0.01) and the control group (P < 0.001). Group A had lower noise level than group B and the control group (P < 0.001), and there was no significant difference in noise level between group B and the control group (P > 0.05). CONCLUSION Ward-noise reduction management combined with MTP management mode can reduce the noise level in the ward and improve the psychological state and sleep quality of patients with heart failure.
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Affiliation(s)
- Yuan Xue
- Cardiology Department, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
| | - Bingqing Lu
- Cardiology Department, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
| | - Yongming He
- Cardiology Department, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
| | - Minxia Lu
- Cardiology Department, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
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Wang M, Bi H, Ma Q. Application of Noise Control Combined with Relaxation Training in Patients with Skin Laser Cosmetology: A Single-center Retrospective Study. Noise Health 2023; 25:203-210. [PMID: 38358235 PMCID: PMC10849011 DOI: 10.4103/nah.nah_42_23] [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: 06/13/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 02/16/2024] Open
Abstract
Objective Noise pollution has been listed as one of the three major types of pollution, along with air and water pollution. Hospitals should pay attention to noise control, which is of great importance for the treatment and rehabilitation of patients. This study focuses on the application value of noise control and relaxation training. Methods This study retrospectively collected and analyzed the clinical data of 184 patients who underwent skin laser cosmetology in Ningbo Yinzhou No. 2 Hospital from January 2021 to December 2022. Twelve patients who did not meet the criteria were excluded, and the remaining 172 patients were divided based on the type of intervention into the control group (CG, n = 82) and the study group (SG, n = 90). The CG received relaxation training and routine noise management, while the SG received noise control combined with relaxation training. The intervention effect was discussed from the aspects of noise, psychology, and satisfaction. Results After the intervention, the SG had overtly lower noise levels and lower scores of anxiety and depression compared to the CG (all P < 0.001). Correlation analysis showed that noise levels were positively correlated with scores of anxiety and depression (r = 0.553, r = 0.592, P < 0.001). The two groups had no significant difference in total satisfaction (P > 0.05). Conclusion Noise poses a significant threat to the human body. Strengthening noise control in hospitals is beneficial for patients' recovery. Combining noise control with relaxation training is an intervention method worthy of clinical application. It can improve the hospitalization environment and reduce the noise levels to a great extent, thereby improving the psychological state of patients and enhancing the medical satisfaction.
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Affiliation(s)
- Miaohao Wang
- Department of Plastic Surgery, The First Affiliated Hospital of Ningbo University, Ningbo 315010, Zhejiang, China
| | - Haiqing Bi
- Department of Dermatology, Ningbo Yinzhou No. 2 Hospital, Ningbo 315100, Zhejiang, China
| | - Qichao Ma
- Department of Dermatology, Ningbo Yinzhou No. 2 Hospital, Ningbo 315100, Zhejiang, China
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Adams C, Walpola R, Schembri A, Harrison R. The HUSH Project: Using codesign to reduce sleep disruptions for patients in hospital. Health Expect 2023; 27:e13881. [PMID: 37740911 PMCID: PMC10768860 DOI: 10.1111/hex.13881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Poor quality sleep in hospitals may be problematic for patients, negatively impacting their recovery and wellbeing. This project aimed to investigate the effectiveness of codesign in addressing key issues affecting sleep disruption in the healthcare setting. METHODS Codesign with patients, staff and consumer representatives was conducted in an acute metropolitan tertiary public hospital in Sydney, Australia. Through a four-stage process, a multimodal intervention to address and reduce the impact of sleep disruptions among hospital inpatients was created. Pre- and post-intervention evaluation was used to determine changes in patient-reported sleep disruption. RESULTS 'The HUSH Project' (Help Us Support Healing) intervention resulted from the codesign process, which included the provision of HUSH Sleep Packs (with earplugs, eye masks and herbal tea), patient information resources, and ward-based Sleep Champions. Survey data from 210 patients revealed a statistically significant decrease in patient-reported noise disturbances for patients in shared rooms following the 4-week intervention period of the HUSH program. CONCLUSION The HUSH Project demonstrated that a novel multimodal intervention may be valuable in reducing sleep disruption in hospitals. These findings also indicate the benefits of using codesign methodology to support improvement projects that seek to enhance patient experiences of care. PATIENT OR PUBLIC CONTRIBUTION This project utilised codesign methodology, which involved significant contributions from patients and consumer representatives, from research conceptualisation into intervention design, implementation and project evaluation.
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Affiliation(s)
- Corey Adams
- Australian Institute of Health Innovation (AIHI)Macquarie UniversitySydneyAustralia
| | - Ramesh Walpola
- School of Population HealthUniversity of New South Wales (UNSW)SydneyAustralia
- School of Health SciencesUniversity of New South Wales (UNSW)SydneyAustralia
| | | | - Reema Harrison
- Australian Institute of Health Innovation (AIHI)Macquarie UniversitySydneyAustralia
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Schafthuizen L, Ista E, van der Heijden M, van Heel L, Maben J, van Rosmalen J, van Eijck CHJ, van Dijk M. Hospitalized Patients' Sleep Quality Compared Between Multioccupancy Rooms and Single-Patient Rooms. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:119-133. [PMID: 37143320 PMCID: PMC10328146 DOI: 10.1177/19375867231168895] [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] [Indexed: 05/06/2023]
Abstract
OBJECTIVES To evaluate patients' sleep quality in a former hospital with two-and four-bedded rooms compared to a new hospital that incorporated evidence-based design features, including exclusively single-patient rooms (SPRs). BACKGROUND Hospitalized patients often report poor sleep quality due to both patient-related factors and hospital environmental factors. It is unclear if staying in an SPR in a hospital designed as a healing environment is associated with better sleep quality. METHODS In a before-after study, sleep quality, duration, and efficiency over 72 hr were measured with a sleep diary, GENEActiv accelerometer, and the Richards-Campbell Sleep Questionnaire (RCSQ) with scores ranging from 0 to 100, with higher scores reflecting better sleep. Participants were either staying alone in the former hospital with two-and four-bedded rooms (Group 1), sharing a room with one to three fellow patients (Group 2), or staying alone in a newly designed hospital with 100% SPRs (Group 3). RESULTS We included 17 patients in Group 1, 32 patients in Group 2, and 56 patients in Group 3. Univariable linear mixed model analysis, controlling for night number, revealed that the RCSQ total score was lowest in Group 2 compared to the other two groups. In the multivariable analysis, the RCSQ score was also the lowest in Group 2, with a significant effect from covariate "use of night medication." CONCLUSION Self-reported sleep quality of hospitalized patients in a hospital with 100% SPRs designed as a healing environment was slightly better than that of patients staying in multioccupancy rooms with fellow patients.
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Affiliation(s)
- Laura Schafthuizen
- Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Erwin Ista
- Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marianne van der Heijden
- Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Liesbeth van Heel
- Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Joost van Rosmalen
- Department of Biostatistics, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Casper H. J. van Eijck
- Department of Surgery, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Monique van Dijk
- Department of Internal Medicine, section Nursing Science, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
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Vreman J, Lemson J, Lanting C, van der Hoeven J, van den Boogaard M. The Effectiveness of the Interventions to Reduce Sound Levels in the ICU: A Systematic Review. Crit Care Explor 2023; 5:e0885. [PMID: 36998528 PMCID: PMC10047617 DOI: 10.1097/cce.0000000000000885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Excessive noise is ubiquitous in the ICU, and there is growing evidence of the negative impact on work performance of caregivers. This study aims to determine the effectiveness of interventions to reduce noise in the ICU. DATA SOURCES Databases of PubMed, EMBASE, PsychINFO, CINAHL, and Web of Science were systematically searched from inception to September 14, 2022. STUDY SELECTION Two independent reviewers assessed titles and abstracts against study eligibility criteria. Noise mitigating ICU studies were included when having at least one quantitative acoustic outcome measure expressed in A-weighted sound pressure level with an experimental, quasi-experimental, or observational design. Discrepancies were resolved by consensus, and a third independent reviewer adjudicated as necessary. DATA EXTRACTION After title, abstract, and full-text selection, two reviewers independently assessed the quality of each study using the Cochrane's Risk Of Bias In Nonrandomized Studies of Interventions tool. Data were synthesized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and interventions were summarized. DATA SYNTHESIS After screening 12,652 articles, 25 articles were included, comprising either a mixed group of healthcare professionals (n = 17) or only nurses (n = 8) from adult or PICU settings. Overall, the methodological quality of the studies was low. Noise reduction interventions were categorized into education (n = 4), warning devices (n = 3), multicomponent programs (n = 15), and architectural redesign (n = 3). Education, a noise warning device, and an architectural redesign significantly decreased the sound pressure levels. CONCLUSIONS Staff education and visual alert systems seem promising interventions to reduce noise with a short-term effect. The evidence of the studied multicomponent intervention studies, which may lead to the best results, is still low. Therefore, high-quality studies with a low risk of bias and a long-term follow-up are warranted. Embedding noise shielding within the ICU-redesign is supportive to reduce sound pressure levels.
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Abstract
INTRODUCTION Sleep deprivation is a relevant problem among patients hospitalized in ICUs. Further, noise is the most critical disruptive factor according to patients. OBJECTIVE To implement scientific evidence-based best practices for noise control in an adult ICU. METHODS This was an evidence-based implementation project of best practices in noise control, conducted in a high-complexity hospital's adult ICU. The intervention consisted of three steps: baseline audit and identification of barriers, implementation of best practices, and a follow-up audit. RESULTS No compliance with best practices was detected in the baseline audit. After the implementation phase, the unit reached compliance levels of 78-88% for most of these criteria only one criterion related to noise level did not match the expected compliance. CONCLUSION Adherence to best practices regarding noise control was satisfactory, achieving more than 70% compliance in the six audit criteria. Only the noise level did not reach the threshold recommended by the WHO - a difficulty reported in other studies. RELEVANCE TO CLINICAL PRACTICE Best practices related to noise control are essential for managing sleep deprivation in ICUs and include changes in the behaviour of involved professionals.
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Bellon F, Beti-Abad A, Pastells-Peiró R, Casado-Ramirez E, Moreno-Casbas T, Gea-Sánchez M, Abad-Corpa E. Effects of nursing interventions to improve inpatients' sleep in intensive and non-intensive care units: Findings from an umbrella review. J Clin Nurs 2022; 32:1963-1978. [PMID: 35170142 DOI: 10.1111/jocn.16251] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 12/24/2021] [Accepted: 01/31/2022] [Indexed: 11/29/2022]
Abstract
AIM This review aimed to synthesise the available reviews on the effects of nursing interventions on sleep quality among patients hospitalised in intensive care and non-intensive care units. BACKGROUND Poor sleep quality is a common fact in hospitalised patients. Nurses can contribute to the improvement of patients' sleep quality and duration. DESIGN A review of intervention reviews was carried out and reported following the PRISMA guidelines and checklist. METHODS We systematically searched for reviews published from January 2009 to December 2019 in PubMed, CINAHL Plus, Scopus, Institute for Scientific Information Web of Science, Joanna Briggs Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Searches were repeated at 24 November 2020 to include the most recent evidence. A narrative synthesis of the results was conducted. RESULTS Nine reviews (representing 109 original papers) met the selection criteria and were included for critical appraisal. Overall, nursing interventions and sleep quality were poorly defined. We grouped the interventions into 3 categories (environmental, barrier and internal interventions) to provide a more comprehensive overview and examine effects of nursing interventions on inpatients sleep quality. Inconsistent results were obtained and low quality of the original articles was reported, making it difficult to establish absolute conclusions. CONCLUSION The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.
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Affiliation(s)
- Filip Bellon
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | - Aintzane Beti-Abad
- Department of Infectious Diseases, Basurto University Hospital, Bilbao, Spain
| | - Roland Pastells-Peiró
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain
| | | | - Teresa Moreno-Casbas
- Nursing and Healthcare Research Unit (Investén-isciii), Madrid, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Montserrat Gea-Sánchez
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, GESEC Group, University of Lleida, Lleida, Spain.,Healthcare Research Group (GRECS), Institute of Biomedical Research in Lleida (IRBLleida), Lleida, Spain.,Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Eva Abad-Corpa
- Biomedical Research Center for Fragility and Healthy Aging (CIBERFES), Madrid, Spain.,University of Murcia-Murcia Health Service (IMIB-Arrixaca), Murcia, Spain
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Capezuti E, Pain K, Alamag E, Chen X, Philibert V, Krieger AC. Systematic review: auditory stimulation and sleep. J Clin Sleep Med 2021; 18:1697-1709. [PMID: 34964434 DOI: 10.5664/jcsm.9860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Auditory stimulation devices (white and pink noise) are used to mask sounds and facilitate relaxation and sleep; however, the effectiveness of this intervention is not well established. This systematic review examined the scientific literature for the effect of specific types of auditory stimulation on sleep outcomes in adults. METHODS The PRISMA Statement guided this review. Searches were conducted in nine databases for intervention studies that could easily be employed in clinical practice. We excluded other types of auditory stimulation (music alone, binaural tones, and synchronization). Two reviewers screened abstracts and full-text articles for eligibility, with conflicts resolved by a third reviewer, and extracted data. Risk of bias was assessed with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. RESULTS 34 studies reported results of 1,103 persons participating in three categories of interventions: white noise (18), pink noise (11), and six multi-audio (some combination of white, pink, music, or silence). Nineteen studies had positive findings in terms of improving sleep outcomes: 6 white noise (33%), 9 pink noise (81.9%), and 4 multi-audio (66.7%). Multi-audio had the lowest (better) risk of bias (mean/SD: 1.67/0.82) compared to white (2.38/0.69) and pink noise (2.36/0.81). CONCLUSIONS Although there was no strong evidence to support use of auditory stimulation, none of the studies reported any adverse effects with short-term application of auditory stimulation during sleep. Future research needs to include confounding factors that can affect outcomes, including one's noise sensitivity, personality, and other conditions or medications that may affect sleep.
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Affiliation(s)
| | | | - Evelyn Alamag
- Hunter College of the City University of New York, New York, NY
| | - XinQing Chen
- Hunter College of the City University of New York, New York, NY
| | | | - Ana C Krieger
- Departments of Medicine, Neurology and Genetic Medicine, Weill Cornell Medical College
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McCullagh MC, Xu J, Dickson VV, Tan A, Lusk SL. Noise Exposure and Quality of Life Among Nurses. Workplace Health Saf 2021; 70:207-219. [PMID: 34915786 DOI: 10.1177/21650799211044365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The purpose of this study was to describe the relationship between noise exposure, selected health conditions, and well-being among nurses. METHODS A secondary analysis was performed on data obtained from 3,818 U.S. nurses who responded to a survey regarding noise exposure, health conditions, stress, professional quality of life, and workplace support. FINDINGS Those who reported high noise exposure reported more health conditions, higher stress and burnout scores, and lower supportive environments. High noise exposure was significantly associated with lower professional quality of life. CONCLUSION/APPLICATION TO PRACTICE Noise may impact the health and quality of professional life of nurses. Occupational health nurses should advocate for the regular monitoring of nurses' exposure to hazardous noise at work, compare it to OSHA permissible levels, and collaborate with the occupational health team to ensure safe noise levels are maintained. Occupational health nurses should advocate for expanded research on effects of noise on health.
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Beck M, Engelke E, Birkelund R, Martinsen B. Aesthetics sets patients 'free' to recover during hospitalization with a neurological disease. A qualitative study. Int J Qual Stud Health Well-being 2021; 16:1992843. [PMID: 34747349 PMCID: PMC8583855 DOI: 10.1080/17482631.2021.1992843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patients with neurological symptoms are particularly sensitive to the quality of the sensory impressions to which they are exposed to during hospitalization. AIM To understand the meaning of aesthetic experiences to patients afflicted with neurological diseases during hospitalization on a neurological unit. METHOD Fifteen patients were invited to "walk and talk" supplemented by semi-structured interviews conducted in newly established aesthetic tableaus within the neurology unit. Data analysis was inspired by the hermeneutic phenomenological methodology of van Manen. RESULT The data analysis identified three overarching themes that unfolded in the patients' experiences of a more aesthetic environment. The themes were: 1) A safe place to avoid noisiness, 2) An invitation to homey activities, 3) A thoughtful consideration for being ill. CONCLUSION Aesthetic elements can enable a thoughtful and needed consideration that withholds momentarily imaginative and hopeful experiences to patients in a vulnerable situation. Thus, aesthetics, together with peace and quietness, can set vulnerable patients free to retreat and recover from the symptoms of neurological diseases.
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Affiliation(s)
- Malene Beck
- Department of Neurology,Zealand University Hospital, Roskilde, Denmark
| | - Eileen Engelke
- College of Health Professions, Lienhard School of Nursing, Pace Universityr, Teachers College, Columbia University, New York City, NY, USA
| | - Regner Birkelund
- Department of Regional Health Research, Institute of Health Service Research (IRS), University of Southern Denmark, Odense, Denmark
| | - Bente Martinsen
- Institute of Health, Department of Nursing Science, Aarhus University, Campus Emdrup, Copenhagen, NV, Denmark
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15
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Conducive environments reduce sleep disturbances and improve sleep quality: a quality improvement project. JBI Evid Implement 2021; 19:105-117. [PMID: 33570338 DOI: 10.1097/xeb.0000000000000265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The current implementation project aimed to improve patients' sleep quality in a hospital by implementing targeted interventions to reduce sleep disturbances. METHODS The Silent Night project was implemented in two general units of an academic tertiary hospital. The project comprised three phases: preimplementation, implementation, and postimplementation. Patient surveys were administered to obtain patients' perspectives on the sources of noise disturbances at night. Noise-monitoring machines were installed in two wards to obtain objective data on noise levels at night. Concurrently, data were collected on noise-generating activities that were observed. RESULTS The overall quality of sleep reported by patients improved by 17% (from 73.5 to 88.9%). Patients' survey reported reduced noise disturbances from direct care activities, environmental noise and medical equipment alarms. The mean noise level in the orthopedics unit reduced significantly from 57.04 to 55.22 dB with a corresponding decrease in noise generating activities by 60% (from 362 to 144). In the geriatric unit, the mean noise level increased from 51.36 to 53.12 dB but is within the National Environmental Agency's permissible noise level of 55 dB even though the noise generating activities reduced significantly by 92.2% (from 954 to 74). CONCLUSION The 'Silent Night' project has successfully reduced noise disturbances generating from environment and nursing care activities and improved patients' sleep quality in the hospital. Sharing sessions regarding sources of noise and the 'Silent Night' poster promoted the awareness of noise disturbances in healthcare professionals, visitors, and patients.
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Aparício C, Panin F. Interventions to improve inpatients' sleep quality in intensive care units and acute wards: a literature review. ACTA ACUST UNITED AC 2021; 29:770-776. [PMID: 32649254 DOI: 10.12968/bjon.2020.29.13.770] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Sleep is essential for the physical and psychological restoration of inpatients, and lack of sleep results in sleep deprivation and poor sleep quality, with potentially harmful consequences. AIM To summarise sleep-promoting interventions in the Intensive care unit (ICU) and acute ward setting. METHOD AND RESULTS Six databases were searched to obtain studies for review and eight studies were selected, appraised, analysed and produced two themes: sleep-disturbing factors and sleep-promoting strategies. Sleep-disturbing factors included environmental factors (such as light and noise), illness-related factors (such as pain, anxiety and discomfort), clinical care and diagnostics. Sleep-promoting strategies included using pharmacological aids (medication) and non-pharmacological aids (reducing noise and disturbances, eye masks, earplugs and educational and behavioural changes). CONCLUSION The literature review showed that both ICU and acute ward settings affect patients' sleep and both use similar strategies to improve this. Nevertheless, noise and sleep disturbances remain the most critical sleep-inhibiting factors in both settings. The review recommended future research should focus on behavioural changes among health professionals to reduce noise and improve patients' sleep.
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Affiliation(s)
- Carlos Aparício
- Professional Doctorate Student, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge
| | - Francesca Panin
- Lecturer, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge
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Capezuti E. Palliative Care Nurse Perceptions of Nonpharmacological Sleep-Promoting Interventions. J Hosp Palliat Nurs 2021; 23:170-177. [PMID: 33633098 DOI: 10.1097/njh.0000000000000733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Poor quality of sleep is common among those with advanced serious illness. Several interventions have been demonstrated to improve sleep; however, the extent to which these are used is unknown. This study describes nurses' perceptions of 36 nonpharmacological sleep-promoting interventions as well as facilitators and barriers to implementing nonpharmacological interventions. A descriptive survey design was used to collect data via an online, anonymous survey from nurses throughout the United States that included demographic items and open-ended questions (barriers and facilitators). The 108 respondents were nurses working in either a hospital (33.3%) or home care/outpatient (54.6%) setting. Among 36 interventions presented, a mean (SD) total score of feasible interventions per respondent was 27.1 (6.5). There were no significant differences in the mean total feasibility score due to practice site, nurse type, or years of experience. Most thought individual belief in the efficacy of the nonpharmacological intervention was an important facilitator whereas perceived lack of value and institutional support were the major barriers. There was an overall appreciation and positive perception of nonpharmacological, sleep-promoting interventions by palliative care nurses. Increasing use will depend on overcoming barriers by identification of specific patient/caregiver and institutional factors in each setting or patient population.
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Affiliation(s)
- Elizabeth Capezuti
- Elizabeth Capezuti, PhD, RN, FAAN, is W.R. Hearst Foundation Chair in Gerontology, Hunter College of the City University of New York, New York
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18
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Kebapcı A, Güner P. "Noise Factory": A qualitative study exploring healthcare providers' perceptions of noise in the intensive care unit. Intensive Crit Care Nurs 2020; 63:102975. [PMID: 33277155 DOI: 10.1016/j.iccn.2020.102975] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 09/21/2020] [Accepted: 11/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to explore healthcare providers' perceptions of noise in the intensive care unit. DESIGN A qualitative exploratory study was conducted using group interviews. SETTING The setting comprised a total of 15 participants (five physicians and ten registered nurses) working in an 18-bed medical surgical intensive care unit at a teaching hospital in Istanbul, Turkey. Semi-structured questions were formulated and used in focus group interviews, after which the recorded interviews were transcribed by the researchers. Thematic analysis was used to identify significant statements and initial codes. FINDINGS Four themes were identified: the meaning of noise, sources of noise, effects of noise and prevention and management of noise. It was found that noise was an inevitable feature of the intensive care unit. The most common sources of noise were human-induced. It was also determined that device-induced noise, such as alarms, did not produce a lot of noise; however, when staff were late in responding, the sound transformed into noise. Furthermore, it was observed that efforts to decrease noise levels taken by staff had only a momentary effect, changing nothing in the long term because the entire team failed to implement any initiatives consistently. The majority of nurses stated that they were now becoming insensitive to the noise due to the constant exposure to device-induced noise. CONCLUSION The data obtained from this study showed that especially human-induced noise threatened healthcare providers' cognitive task functions, concentration and job performance, impaired communication and negatively affected patient safety. In addition, it was determined that any precautions taken to reduce noise were not fully effective. A team approach should be used in managing noise in intensive care units with better awareness.
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Affiliation(s)
- Ayda Kebapcı
- Koç University School of Nursing, Istanbul, Turkey.
| | - Perihan Güner
- Istanbul Bilgi University School of Health Sciences, Istanbul, Turkey
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19
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Rottweiler BA, Flynn Makic MB. Pragmatic Nonpharmacologic Interventions to Improve Patient Sleep and Decrease Delirium. J Perianesth Nurs 2020; 36:194-196. [PMID: 33262013 DOI: 10.1016/j.jopan.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/09/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Brian A Rottweiler
- Civilian Institution Program, Air Force Institute of Technology, Wright-Patterson Air Force Base, OH
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Astin F, Stephenson J, Wakefield J, Evans B, Rob P, Joanna G, Harris E. Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England. Open Nurs J 2020. [DOI: 10.2174/1874434602014010080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Hospital in-patients need sleep so that restorative process and healing can take place. However, over one third of in-patients experience sleep disturbance, often caused by noise. This can compromise patients’ perceptions of care quality and cause physical and psychological ill health.
Aims:
To assess 1) in-patients sleep quality, quantity, reported sources of sleep disturbance and their suggestions for improvement 2) objectively measure decibel levels recorded at night.
Methods:
This descriptive study conducted in a Medical Assessment Unit used multi-methods; a semi-structured ‘sleep experience’ questionnaire administered to a purposive sample of in-patients; recording of night-time noise levels, on 52 consecutive nights, using two calibrated Casella sound level meters.
Results:
Patient ratings of ‘in-hospital’ sleep quantity (3.25; 2.72 SD) and quality (2.91; 2.56 SD) was poorer compared to ‘home’ sleep quantity (5.07; 2.81 SD) and quality (5.52; 2.79 SD). The difference in sleep quality (p<0.001) and quantity (p<0.001) ratings whilst in hospital, compared to at home, was statistically significant. Care processes, noise from other patients and the built environment were common sources of sleep disturbance. Participants’ suggestions for improvement were similar to interventions identified in current research. The constant noise level ranged from 38-57 decibels (equivalent to an office environment), whilst peak levels reached a maximum of 116 decibels, (equivalent to banging a car door one metre away).
Conclusion:
The self-rated patient sleep experience was significantly poorer in hospital, compared to home. Noise at night contributed to sleep disturbance. Decibel levels were equivalent to those reported in other international studies. Data informed the development of a ‘Sleep Smart’ toolkit designed to improve the in-patient sleep experience.
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