1
|
Xie M, Deng Z, Xiang Z. Acoustic characteristics of bedrooms in two types of long-term care facilities in China. Heliyon 2024; 10:e27121. [PMID: 38486778 PMCID: PMC10937692 DOI: 10.1016/j.heliyon.2024.e27121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
The aim of this study was to quantitatively determine the acoustic characteristics of bedrooms in two types of long-term care facilities in China. Objective acoustic conditions, including noise levels and reverberation times, were measured through a series of acoustic measurements in twelve bedrooms in two nursing homes and three adult care homes in Kunming city, China. The impacts of noise and sound preferences were evaluated through a questionnaire survey administered to residents and nursing staff. In terms of the sound field, the background noise levels in most measured bedrooms exceeded the WHO's recommended value (30 dBA) by approximately 10-15 dBA. Compared to those in adult care homes, the noise levels in nursing homes were approximately 5-7 dBA higher during the daytime and 2-3 dBA higher during the nighttime due to frequent nursing activities. Moreover, noise levels were 5-15 dBA higher in roadside bedrooms. The reverberation time of five bedrooms reached 0.8 s at low frequency (125 Hz) due to their large space and absence of sound-absorbing materials. The questionnaire showed that noise sources were mainly perceived as coming from corridors and out-of-windows by residents and nursing staff. Traffic noise, residents' yelling in pain (just in nursing homes) and footsteps were considered the most noticeable noises, which may have had negative effects on participants' sleep quality, health, and emotional state. Moreover, the residents in roadside bedrooms reported that noise had a greater impact on their sleep (p < 0.01). Compared to artificial and mechanical sounds, participants preferred nature sounds, such as streams and birds, which were significantly (p < 0.01) positively correlated with age.
Collapse
Affiliation(s)
- Mingxuan Xie
- Faculty of Architecture and City Planning, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China
| | - Zhixiao Deng
- Faculty of Architecture and City Planning, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China
| | - Zhengnan Xiang
- Faculty of Architecture and City Planning, Kunming University of Science and Technology, Kunming, Yunnan, 650500, China
| |
Collapse
|
2
|
Lärmbelastung einer neonatologischen Intensivstation. ZENTRALBLATT FÜR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2022. [DOI: 10.1007/s40664-022-00486-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
3
|
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.
Collapse
|
4
|
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.
Collapse
Affiliation(s)
- Ayda Kebapcı
- Koç University School of Nursing, Istanbul, Turkey.
| | - Perihan Güner
- Istanbul Bilgi University School of Health Sciences, Istanbul, Turkey
| |
Collapse
|
5
|
Joseph BE, Mehazabeen H, U M. Noise pollution in hospitals - A study of public perception. Noise Health 2020; 22:28-33. [PMID: 33243965 PMCID: PMC7986457 DOI: 10.4103/nah.nah_13_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Hospitals are categorized under silent zone, but noise pollution in this setup is inevitable. The noise in hospitals may have adverse effects on the patients, caregivers and professionals working in hospitals. Aim: The aim of the study was to determine awareness of public regarding noise pollution in hospitals, its health effects and mitigation measures. Method: The present study was an internet-based questionnaire survey. The questionnaire consisted of a common Section-I for all participants and an additional Section-II for participants of the study who were Audiologists. Descriptive statistical analysis was done on the acquired data. Results: 174 completed questionnaires were received and analysed, out of which 108 were general public and 66 were Audiologists. The data analysis revealed that the public is aware of the presence of noise in hospitals, some of its overt health effects and measures that can be taken to control the noise pollution in hospitals. Only 22.7% Audiologists who participated in the study were aware of the more technical aspects like permissible noise level in hospitals and their response was similar to that of the general public. Conclusion: Though the public is aware of some of the basic facts related to noise in hospitals, there is a need to create public awareness and to train Audiologists regarding hearing conservation program in hospital setups.
Collapse
Affiliation(s)
| | | | - Monisha U
- Nitte Institute of Speech and Hearing, Mangalore, Karnataka, India
| |
Collapse
|
6
|
Cvach M, Doyle P, Wong SY, Letnaunchyn K, Dell D, Mamaril M. Decreasing Pediatric PACU Noise Level and Alarm Fatigue: A Quality Improvement Initiative to Improve Safety and Satisfaction. J Perianesth Nurs 2020; 35:357-364. [PMID: 32362515 DOI: 10.1016/j.jopan.2020.01.011] [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: 11/11/2019] [Revised: 01/21/2020] [Accepted: 01/23/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To describe how a pediatric postanesthesia care unit used a two-phased approach of bundled interventions to reduce unit noise levels and improve staff perceptions of their work environment. DESIGN Pre/post design. METHODS Postanesthesia care unit sound levels and monitor alarms were measured at baseline and after implementing both project phases. Nursing staff members were surveyed at baseline and after completion of the project. FINDINGS Monitor alarms were reduced by more than 50% after Phase I. However, noise measurement data did not reflect a difference in sound levels between baseline and intervention phases. Despite this, staff perceived the unit as much quieter. CONCLUSIONS The reduction in monitor alarms did not cause an appreciable change in sound levels as measured by noise dosimeters in either intervention phase. Despite these findings, nurses perceived a quieter and more pleasant workplace. These impressions might have resulted from subjective expectations versus actual volume levels, or they might owe to the reduction in incidence of alarms themselves, which they had viewed as nuisance sounds.
Collapse
Affiliation(s)
- Maria Cvach
- Department of Integrated Healthcare Delivery, Johns Hopkins Health System, Baltimore, MD.
| | - Peter Doyle
- Department of Clinical Engineering, The Johns Hopkins Hospital, Baltimore, MD
| | - Sereniti Young Wong
- Department of Nursing, The Johns Hopkins Hospital-The Charlotte R. Bloomberg Children's Center, Baltimore, MD
| | - Kimberly Letnaunchyn
- Department of Nursing, The Johns Hopkins Hospital-The Charlotte R. Bloomberg Children's Center, Baltimore, MD
| | - Deborah Dell
- Department of Nursing, The Johns Hopkins Hospital-The Charlotte R. Bloomberg Children's Center, Baltimore, MD
| | - Myrna Mamaril
- Department of Nursing, The Johns Hopkins Hospital-The Charlotte R. Bloomberg Children's Center, Baltimore, MD
| |
Collapse
|
7
|
Betwixt and between: a surgical post-acute treatment unit (SPA) for the optimal care of elderly patients with isolated hip fractures. Aging Clin Exp Res 2019; 31:1743-1753. [PMID: 30968288 DOI: 10.1007/s40520-019-01119-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/03/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND A performance improved project identified elderly trauma patients to have a disproportionate incidence of complications. AIMS The purpose of this study was to assess the efficacy of a small specialty care unit to decrease complications in patients who no longer warrant care in an intensive care unit (ICU). METHODS A surgical post-acute treatment unit (SPA) was developed with focused attention to cognition, nutrition, respiration, and mobilization needs of patients who no longer had physiologic need for an intensive care unit environment, but were still in need of increased attention at the bedside. RESULTS While ICU and hospital lengths of stay were unchanged, patients placed in the SPA experienced less complications and required less unplanned ICU re-admissions. DISCUSSION Geriatric patients, especially the elderly, are not simply old adults. They have unique needs as a consequence of the aging process, which can be encompassed by four pillars of intercession: cognition, nutrition, respiration, and mobilization. CONCLUSIONS By adapting a physical environment supported by bedside attention to address the interwoven needs of geriatric and elderly patients who no longer care in an ICU, complications and unplanned return admissions to the ICU can be decreased. LEVEL OF EVIDENCE III.
Collapse
|
8
|
Actigraphic measures of sleep on the wards after ICU discharge. J Crit Care 2019; 54:163-169. [DOI: 10.1016/j.jcrc.2019.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 11/18/2022]
|
9
|
Wallis R, Harris E, Lee H, Davies W, Astin F. Environmental noise levels in hospital settings: A rapid review of measurement techniques and implementation in hospital settings. Noise Health 2019; 21:200-216. [PMID: 32820743 PMCID: PMC7650850 DOI: 10.4103/nah.nah_19_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 12/31/2019] [Accepted: 01/16/2020] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Hospitals provide treatment to improve patient health and well-being but the characteristics of the care environment receive little attention. Excessive noise at night has a negative impact on in-patient health through disturbed sleep. To address this hospital staff must measure night-time environmental noise levels. Therefore, an understanding of environmental noise measurement techniques is required. In this review, we aim to 1) provide a technical overview of factors to consider when measuring environmental noise in hospital settings; 2) conduct a rapid review on the equipment and approaches used to objectively measured noise in hospitals and identify methodological limitations. DESIGN : A rapid review of original research articles, from three databases, published since 2008. Studies were included if noise levels were objectively measured in a hospital setting where patients were receiving treatment. RESULTS 1429 articles were identified with 76 included in the review. There was significant variability in the approaches used to measure environmental noise in hospitals. Only 14.5% of studies contained sufficient information to support replication of the measurement process. Most studies measured noise levels using a sound level meter positioned closed to a patient's bed area in an intensive care unit. CONCLUSION : Unwanted environmental noise in hospital setting impacts negatively on patient and staff health and well-being. However, this literature review found that the approaches used to objectively measure noise level in hospital settings have been inconsistent and poorly reported. Recommendations on best-practice methods to measure noise levels in hospital environments are provided.
Collapse
Affiliation(s)
- Rory Wallis
- Applied Psychoacoustics Laboratory, University of Huddersfield, Huddersfield, HD1 3DH, United Kingdom
| | - Emma Harris
- Centre for Applied Research in Health, University of Huddersfield, Huddersfield, HD1 3DH, United Kingdom
| | - Hyunkook Lee
- Applied Psychoacoustics Laboratory, University of Huddersfield, Huddersfield, HD1 3DH, United Kingdom
| | - William Davies
- Acoustics Research Centre, University of Salford, Salford, M5 4WT, United Kingdom
| | - Felicity Astin
- Centre for Applied Research in Health, University of Huddersfield, Huddersfield, HD1 3DH, United Kingdom
| |
Collapse
|
10
|
Are noise reduction interventions effective in adult ward settings? A systematic review and meta analysis. Appl Nurs Res 2018; 44:6-17. [DOI: 10.1016/j.apnr.2018.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 08/20/2018] [Accepted: 08/27/2018] [Indexed: 11/22/2022]
|
11
|
Implementation of Quiet Time for Noise Reduction on a Medical-Surgical Unit. ACTA ACUST UNITED AC 2016; 46:669-674. [DOI: 10.1097/nna.0000000000000424] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
12
|
Miner SES, Pahal D, Nichols L, Darwood A, Nield LE, Wulffhart Z. Sleep Disruption is Associated with Increased Ventricular Ectopy and Cardiac Arrest in Hospitalized Adults. Sleep 2016; 39:927-35. [PMID: 26715226 DOI: 10.5665/sleep.5656] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 11/26/2015] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To determine whether sleep disruption increases ventricular ectopy and the risk of cardiac arrest in hospitalized patients. METHODS Hospital emergency codes (HEC) trigger multiple hospital-wide overhead announcements. In 2014 an electronic "code white" program was instituted to protect staff from violent patients. This resulted in an increase in nocturnal HEC. Telemetry data was examined between September 14 and October 2, 2014. The frequency of nocturnal announcements was correlated with changes in frequency of premature ventricular complexes per hour (PVC/h). Cardiac arrest data were examined over a 3-y period. All HEC were assumed to have triggered announcements. The relationship between nocturnal HEC and the incidence of subsequent cardiac arrest was examined. RESULTS 2,603 hours of telemetry were analyzed in 87 patients. During nights with two or fewer announcements, PVC/h decreased 33% and remained 30% lower the next day. On nights with four or more announcements, PVC/h increased 23% (P < 0.001) and further increased 85% the next day (P = 0.001). In 2014, following the introduction of the code white program, the frequency of all HEC increased from 1.1/day to 6.2/day (P < 0.05). The frequency of cardiac arrest/24 h rose from 0.46/day in 2012-2013 to 0.62/day in 2014 (P = 0.001). During daytime hours (06:00-22:00), from 2012 through 2014, the frequency of cardiac arrest following zero, one or at least two nocturnal HEC were 0.331 ± 0.03, 0.396 ± 0.04 and 0.471 ± 0.09 respectively (R(2) = 0.99, P = 0.03). CONCLUSIONS Sleep disruption is associated with increased ventricular ectopy and increased frequency of cardiac arrest.
Collapse
Affiliation(s)
- Steven Edward Stuart Miner
- Southlake Regional Health Center, Newmarket, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Dev Pahal
- Southlake Regional Health Center, Newmarket, Ontario, Canada
| | - Laurel Nichols
- Southlake Regional Health Center, Newmarket, Ontario, Canada
| | - Amanda Darwood
- Southlake Regional Health Center, Newmarket, Ontario, Canada
| | - Lynne Elizabeth Nield
- University of Toronto, Toronto, Ontario, Canada.,Labatt Heart Center, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zaev Wulffhart
- Southlake Regional Health Center, Newmarket, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
13
|
|
14
|
Kol E, Demircan A, Erdoğan A, Gencer Z, Erengin H. The Effectiveness of Measures Aimed at Noise Reduction in an Intensive Care Unit. Workplace Health Saf 2015; 63:539-45. [DOI: 10.1177/2165079915607494] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Noise is a significant problem for both hospitalized patients and health care workers. This study aimed to determine the effectiveness of noise reduction strategies in an intensive care unit. Noise was measured in two phases. In the first phase, the unit’s present level of noise was established over 3 weeks between January 1, 2012, and February 1, 2012. During the month following initial measurements, noise reduction interventions, including staff education and physical space arrangement, were initiated, and device alarms were checked. The second phase of measurement was conducted during another 3-week period (between June 1, 2012, and July 1, 2012). The noise levels before and after noise reduction interventions were calculated as 67.6 dB-A and 56 dB-A; the difference between the two levels was statistically significant ( p < .05). The interventions were effective in reducing noise in intensive care units; the interventions are relatively easy and low cost.
Collapse
|
15
|
Kol E, Aydın P, Dursun O. The effectiveness of environmental strategies on noise reduction in a pediatric intensive care unit: creation of single-patient bedrooms and reducing noise sources. J SPEC PEDIATR NURS 2015; 20:210-7. [PMID: 25943006 DOI: 10.1111/jspn.12116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE Noise is a substantial problem for both patients and healthcare workers in hospitals. This study aimed to determine the effectiveness of environmental strategies (creating single-patient rooms and reducing noise sources) in noise reduction in a pediatric intensive care unit. DESIGN AND METHODS Noise measurement in the unit was conducted in two phases. In the first phase, measurements aimed at determining the unit's present level of noise were performed over 4 weeks in December 2013. During the month following the first measurement phase, the intensive care unit (ICU) was moved to a new location and noise-reducing strategies were implemented. The second phase, in May 2014, measured noise levels in the newly constructed environment. RESULTS The noise levels before and after environmental changes were statistically significant at 72.6 dB-A and 56 dB-A, respectively (p < .05). PRACTICE IMPLICATIONS Single-patient rooms and noise-reducing strategies can be effective in controlling environmental noise in the ICU.
Collapse
Affiliation(s)
- Emine Kol
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Perihan Aydın
- Pediatric Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - Oguz Dursun
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Akdeniz University, Antalya, Turkey
| |
Collapse
|
16
|
Bano M, Chiaromanni F, Corrias M, Turco M, De Rui M, Amodio P, Merkel C, Gatta A, Mazzotta G, Costa R, Montagnese S. The influence of environmental factors on sleep quality in hospitalized medical patients. Front Neurol 2014; 5:267. [PMID: 25566173 PMCID: PMC4263101 DOI: 10.3389/fneur.2014.00267] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 11/27/2014] [Indexed: 11/29/2022] Open
Abstract
Introduction: Sleep–wake disturbances are common in hospitalized patients but few studies have assessed them systematically. The aim of the present study was to assess sleep quality in a group of medical inpatients, in relation to environmental factors, and the switch to daylight-saving time. Methods: Between March and April 2013, 118 consecutive inpatients were screened and 99 (76 ± 11 years; hospitalization: 8 ± 7 days) enrolled. They slept in double or quadruple rooms, facing South/South-East, and were qualified as sleeping near/far from the window. They underwent daily sleep assessment by standard questionnaires/diaries. Illuminance was measured by a luxmeter at each patient’s eye-level, four times per day. Noise was measured at the same times by a phonometer. Information was recorded on room lighting, position of the rolling shutters and number/type of extra people in the room. Results: Compliance with sleep-wake assessment was poor, with a range of completion of 2–59%, depending on the questionnaires. Reported sleep quality was sufficient and sleep timing dictated by hospital routine; 33% of the patients reported one/more sleepless nights. Illuminance was generally low, and rolling shutters half-way down for most of the 24 h. Patients who slept near the window were exposed to more light in the morning (i.e., 222 ± 72 vs. 174 ± 85 lux, p < 0.05 before the switch; 198 ± 72 vs. 141 ± 137 lux, p < 0.01 after the switch) and tended to sleep better (7.3 ± 1.8 vs. 5.8 ± 2.4 on a 1–10 scale, before the switch, p < 0.05; 7.7 ± 2.3 vs. 6.6 ± 1.8, n.s. after the switch). Noise levels were higher than recommended for care units but substantially comparable across times/room types. No significant differences were observed in sleep parameters before/after the switch. Conclusion: Medical wards appear to be noisy environments, in which limited attention is paid to light/dark hygiene. An association was observed between sleep quality and bed position/light exposure, which is worthy of further study.
Collapse
Affiliation(s)
- Milena Bano
- Department of Medicine, University of Padova , Padova , Italy
| | | | - Michela Corrias
- Department of Medicine, University of Padova , Padova , Italy
| | - Matteo Turco
- Department of Medicine, University of Padova , Padova , Italy
| | - Michele De Rui
- Department of Medicine, University of Padova , Padova , Italy
| | - Piero Amodio
- Department of Medicine, University of Padova , Padova , Italy
| | - Carlo Merkel
- Department of Medicine, University of Padova , Padova , Italy
| | - Angelo Gatta
- Department of Medicine, University of Padova , Padova , Italy
| | | | - Rodolfo Costa
- Department of Biology, University of Padova , Padova , Italy
| | - Sara Montagnese
- Department of Medicine, University of Padova , Padova , Italy
| |
Collapse
|
17
|
Lee SY, Chaudhury H, Hung L. Exploring staff perceptions on the role of physical environment in dementia care setting. DEMENTIA 2014; 15:743-55. [DOI: 10.1177/1471301214536910] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study explored staff perceptions of the role of physical environment in dementia care facilities in affecting resident’s behaviors and staff care practice. We conducted focus groups with staff (n = 15) in two purposely selected care facilities in Vancouver, Canada. Focus group participants included nurses, care aides, recreation staff, administrative staff, and family. Data analysis revealed two themes: (a) a supportive physical environment contributes positively to both quality of staff care interaction and residents’ quality of life and (b) an unsupportive physical environment contributes negatively to residents’ quality of life and thereby makes the work of staff more challenging. The staff participants collectively viewed that comfort, familiarity, and an organized space were important therapeutic resources for supporting the well-being of residents. Certain behaviors of residents were influenced by poor environmental factors, including stimulation overload, safety risks, wayfinding challenge, and rushed care. This study demonstrates the complex interrelationships among the dementia care setting’s physical environment, staff experiences, and residents’ quality of life.
Collapse
Affiliation(s)
- Sook Y Lee
- Research Center Design and Health, Sweden
| | | | | |
Collapse
|
18
|
Cranmer K, Davenport L. Quiet time in a pediatric medical/surgical setting. J Pediatr Nurs 2013; 28:400-5. [PMID: 23531464 DOI: 10.1016/j.pedn.2013.02.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 02/25/2013] [Indexed: 11/28/2022]
|
19
|
Alway A, Halm MA, Shilhanek M, St. Pierre J. Do earplugs and eye masks affect sleep and delirium outcomes in the critically ill? Am J Crit Care 2013; 22:357-60. [PMID: 23817826 DOI: 10.4037/ajcc2013545] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Ann Alway
- Ann Alway is a critical care clinical nurse specialist, Margo A. Halm is the director of nursing research, professional practice, and Magnet; Misti Shilhanek is a nurse discharge caller, and Jeanne St. Pierre is a gerontological clinical nurse specialist at Salem Hospital in Salem, Oregon
| | - Margo A. Halm
- Ann Alway is a critical care clinical nurse specialist, Margo A. Halm is the director of nursing research, professional practice, and Magnet; Misti Shilhanek is a nurse discharge caller, and Jeanne St. Pierre is a gerontological clinical nurse specialist at Salem Hospital in Salem, Oregon
| | - Misti Shilhanek
- Ann Alway is a critical care clinical nurse specialist, Margo A. Halm is the director of nursing research, professional practice, and Magnet; Misti Shilhanek is a nurse discharge caller, and Jeanne St. Pierre is a gerontological clinical nurse specialist at Salem Hospital in Salem, Oregon
| | - Jeanne St. Pierre
- Ann Alway is a critical care clinical nurse specialist, Margo A. Halm is the director of nursing research, professional practice, and Magnet; Misti Shilhanek is a nurse discharge caller, and Jeanne St. Pierre is a gerontological clinical nurse specialist at Salem Hospital in Salem, Oregon
| |
Collapse
|
20
|
Nurses' impact on the hospital environment: lessening or contributing to the chaos? Geriatr Nurs 2013; 34:72-74. [PMID: 23499012 DOI: 10.1016/j.gerinurse.2012.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
21
|
Noise in hospital intensive care units—a critical review of a critical topic. J Crit Care 2012; 27:522.e1-9. [DOI: 10.1016/j.jcrc.2011.09.003] [Citation(s) in RCA: 113] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 08/25/2011] [Accepted: 09/03/2011] [Indexed: 11/24/2022]
|
22
|
Thomas KP, Salas RE, Gamaldo C, Chik Y, Huffman L, Rasquinha R, Hoesch RE. Sleep rounds: a multidisciplinary approach to optimize sleep quality and satisfaction in hospitalized patients. J Hosp Med 2012; 7:508-12. [PMID: 22407674 DOI: 10.1002/jhm.1934] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 02/10/2012] [Accepted: 02/12/2012] [Indexed: 11/08/2022]
Abstract
BACKGROUND Poor sleep has adverse affects on heath, yet few studies have addressed the goal of improving sleep among hospitalized patients. We evaluated the effectiveness of a sleep-promoting intervention on the quality and quantity of sleep among inpatients. METHODS This study was conducted on a neurological ward in a large, tertiary care hospital. Sleep quality, quantity, and disruptors were assessed using questionnaires completed by patients during their hospital stay and Press Ganey surveys completed retrospectively. Room noise was also measured using noise meters. Data from each of 4 chronological phases of the study (baseline, basic intervention, "washout," and deluxe intervention) were analyzed. In the intervention phases, nurses conducted "Sleep Rounds" at bedtime, during which sleep-promoting practices were implemented, including lights out, television off, temperature adjustment, and a final restroom usage. RESULTS Patients reported 5 (interquartile range [IQR] 3) hours of sleep per night, awoke 3 (IQR 3) times nightly, and reported a median sleep latency of 11 to 15 minutes. Pain, staff interruptions, and roommates were the most significant barriers to good sleep. Noise levels were adequately low (35-40 dB) at night but were not positively impacted by our sleep-promoting interventions. Patients perceived noise on the unit to be worse during phases of the study in which there was no intervention. CONCLUSIONS Patient perception of sleep experience improved during the phases in which Sleep Rounds were implemented, despite the fact that there was no measurable improvement in sleep or sleep-disrupting factors.
Collapse
Affiliation(s)
- Katherine P Thomas
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | | | | |
Collapse
|
23
|
Drahota A, Ward D, Mackenzie H, Stores R, Higgins B, Gal D, Dean TP. Sensory environment on health-related outcomes of hospital patients. Cochrane Database Syst Rev 2012; 2012:CD005315. [PMID: 22419308 PMCID: PMC6464891 DOI: 10.1002/14651858.cd005315.pub2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hospital environments have recently received renewed interest, with considerable investments into building and renovating healthcare estates. Understanding the effectiveness of environmental interventions is important for resource utilisation and providing quality care. OBJECTIVES To assess the effect of hospital environments on adult patient health-related outcomes. SEARCH METHODS We searched: the Cochrane Central Register of Controlled Trials (last searched January 2006); MEDLINE (1902 to December 2006); EMBASE (January 1980 to February 2006); 14 other databases covering health, psychology, and the built environment; reference lists; and organisation websites. This review is currently being updated (MEDLINE last search October 2010), see Studies awaiting classification. SELECTION CRITERIA Randomised and non-randomised controlled trials, controlled before-and-after studies, and interrupted times series of environmental interventions in adult hospital patients reporting health-related outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently undertook data extraction and 'Risk of bias' assessment. We contacted authors to obtain missing information. For continuous variables, we calculated a mean difference (MD) or standardized mean difference (SMD), and 95% confidence intervals (CI) for each study. For dichotomous variables, we calculated a risk ratio (RR) with 95% confidence intervals (95% CI). When appropriate, we used a random-effects model of meta-analysis. Heterogeneity was explored qualitatively and quantitatively based on risk of bias, case mix, hospital visit characteristics, and country of study. MAIN RESULTS Overall, 102 studies have been included in this review. Interventions explored were: 'positive distracters', to include aromas (two studies), audiovisual distractions (five studies), decoration (one study), and music (85 studies); interventions to reduce environmental stressors through physical changes, to include air quality (three studies), bedroom type (one study), flooring (two studies), furniture and furnishings (one study), lighting (one study), and temperature (one study); and multifaceted interventions (two studies). We did not find any studies meeting the inclusion criteria to evaluate: art, access to nature for example, through hospital gardens, atriums, flowers, and plants, ceilings, interventions to reduce hospital noise, patient controls, technologies, way-finding aids, or the provision of windows. Overall, it appears that music may improve patient-reported outcomes such as anxiety; however, the benefit for physiological outcomes, and medication consumption has less support. There are few studies to support or refute the implementation of physical changes, and except for air quality, the included studies demonstrated that physical changes to the hospital environment at least did no harm. AUTHORS' CONCLUSIONS Music may improve patient-reported outcomes in certain circumstances, so support for this relatively inexpensive intervention may be justified. For some environmental interventions, well designed research studies have yet to take place.
Collapse
Affiliation(s)
- Amy Drahota
- UK Cochrane Centre, National Institute for Health Research, Oxford, UK.
| | | | | | | | | | | | | |
Collapse
|
24
|
Zborowsky T, Bunker-Hellmich L, Morelli A, O'Neill M. Centralized vs. decentralized nursing stations: effects on nurses' functional use of space and work environment. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2011; 3:19-42. [PMID: 21165850 DOI: 10.1177/193758671000300404] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Evidence-based findings of the effects of nursing station design on nurses' work environment and work behavior are essential to improve conditions and increase retention among these fundamental members of the healthcare delivery team. The purpose of this exploratory study was to investigate how nursing station design (i.e., centralized and decentralized nursing station layouts) affected nurses' use of space, patient visibility, noise levels, and perceptions of the work environment. BACKGROUND Advances in information technology have enabled nurses to move away from traditional centralized paper-charting stations to smaller decentralized work stations and charting substations located closer to, or inside of, patient rooms. Improved understanding of the trade-offs presented by centralized and decentralized nursing station design has the potential to provide useful information for future nursing station layouts. This information will be critical for understanding the nurse environment "fit." METHODS The study used an exploratory design with both qualitative and quantitative methods. Qualitative data regarding the effects of nursing station design on nurses' health and work environment were gathered by means of focus group interviews. Quantitative data-gathering techniques included place- and person-centered space use observations, patient visibility assessments, sound level measurements, and an online questionnaire regarding perceptions of the work environment. RESULTS Nurses on all units were observed most frequently performing telephone, computer, and administrative duties. Time spent using telephones, computers, and performing other administrative duties was significantly higher in the centralized nursing stations. Consultations with medical staff and social interactions were significantly less frequent in decentralized nursing stations. There were no indications that either centralized or decentralized nursing station designs resulted in superior visibility. Sound levels measured in all nursing stations exceeded recommended levels during all shifts. No significant differences were identified in nurses' perceptions of work control-demand-support in centralized and decentralized nursing station designs. CONCLUSIONS The "hybrid" nursing design model in which decentralized nursing stations are coupled with centralized meeting rooms for consultation between staff members may strike a balance between the increase in computer duties and the ongoing need for communication and consultation that addresses the conflicting demands of technology and direct patient care.
Collapse
|
25
|
|
26
|
|