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Sarkar M, Rock P, Rowen L, Hong C. Increased Patient Satisfaction in the Postanesthesia Care Unit with the Implementation of a Controlled Noise Reduction Program. J Perianesth Nurs 2021; 36:3-7. [DOI: 10.1016/j.jopan.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/28/2020] [Accepted: 05/02/2020] [Indexed: 11/25/2022]
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Schmidt N, Gerber SM, Zante B, Gawliczek T, Chesham A, Gutbrod K, Müri RM, Nef T, Schefold JC, Jeitziner MM. Effects of intensive care unit ambient sounds on healthcare professionals: results of an online survey and noise exposure in an experimental setting. Intensive Care Med Exp 2020; 8:34. [PMID: 32705428 PMCID: PMC7376325 DOI: 10.1186/s40635-020-00321-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/03/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Noise levels on intensive care units (ICUs) are typically elevated. While many studies reported negative effects of ICU ambient sounds on patients, only few investigated noise as a factor to influence well-being or performance in healthcare professionals. METHODS An online survey in the German-speaking part of Switzerland was conducted to assess how ICU soundscapes are subjectively perceived by healthcare professionals. The questionnaire was answered by 348 participants. Additionally, effects of noise on working memory performance were evaluated in an experimental noise exposure setting. Twenty-six healthcare professionals and 27 healthy controls performed a 2-back object-location task while being exposed to either ICU or pink noise. RESULTS Survey results demonstrate that a majority of participants was aware of heightened noise levels. Participants reported that mostly well-being, performance, and attention could be reduced, along with subjective annoyance and fatigue by ICU ambient sounds. Although no significant effects of noise exposure on working memory performance was observed, self-assessments revealed significantly higher stress levels, increased annoyance and distraction ratings as well as decreased confidence in performance after ICU-noise exposure. CONCLUSION Subjective assessments indicate that heightened noise levels on ICUs induce annoyance, with heightened stress levels, impaired well-being, and reduced performance being potential consequences. Empirical evidence with objective and physiological measures is warranted.
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Affiliation(s)
- Nadine Schmidt
- Gerontechnology & Rehabilitation Group, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland
| | - Stephan M Gerber
- Gerontechnology & Rehabilitation Group, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland
| | - Björn Zante
- Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, CH-3010, Bern, Switzerland
| | - Tom Gawliczek
- Hearing Research Laboratory, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland
| | - Alvin Chesham
- Gerontechnology & Rehabilitation Group, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland
| | - Klemens Gutbrod
- Department of Neurology, University Neurorehabilitation, University Hospital Bern (Inselspital), University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - René M Müri
- Gerontechnology & Rehabilitation Group, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland
- Department of Neurology, University Neurorehabilitation, University Hospital Bern (Inselspital), University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Tobias Nef
- Gerontechnology & Rehabilitation Group, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland.
- ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse 50, CH-3008, Bern, Switzerland.
| | - Joerg C Schefold
- Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, CH-3010, Bern, Switzerland
| | - Marie-Madlen Jeitziner
- Department of Intensive Care Medicine, University Hospital Bern (Inselspital), University of Bern, CH-3010, Bern, Switzerland
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Manukyan AL, Grigoryan AS, Hunanyan LS, Harutyunyan HA, Manukyan MV, Melkonyan MM. Adrenergic alpha-2 receptor antagonists cease augmented oxidation of plasma proteins and anxiety of rats caused by chronic noise exposure. Noise Health 2020; 22:63-69. [PMID: 33402606 PMCID: PMC8000136 DOI: 10.4103/nah.nah_31_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 12/30/2019] [Accepted: 01/01/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Noise is one of the environmental factors, which is considered as a powerful stressor for the organism. Generally, the acoustic stress affects the behavior and physiological state of humans and animals. AIMS The goal of this study is to investigate the relationship between chronic noise exposure and the effects of adrenergic alpha-2 receptor antagonists, beditin and mesedin, on the anxiety and oxidation of plasma proteins and fibrinogen in rats. METHODS The experiments were carried out on non-linear albino male rats, divided into four groups (six animals in each): 1. Healthy controls 2. Exposed to noise of a level 91 dB(A), eight hours daily, during 7, 30 and 60 days; 3. Injected with 2 mg/kg of beditin (2-(2-amino-4-thiazolyl)-1,4-benzodioxane hydrochloride)); 4. Injected with 10 mg/kg mesedin (2-(2-methyl-amino-thiozolyl)-1,4-benzodioxane hydrochloride). For evaluating the cognitive impairment, the Any-maze test was applied. The level of carbonylation of proteins was assessed by reaction with 2,4-dinitrophenylhydrazine, spectrophotometrically. RESULTS Chronic noise decreased locomotor activity and increased anxiety and oxidation of plasma protein and fibrinogen. Intensity of these changes were dependent on the duration of noise exposure. CONCLUSION The Alpha 2 adrenoblockers alleviate oxidative modification of plasma proteins and reduce the cognitive impairment caused by chronic exposure to noise.
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Affiliation(s)
- Ashkhen Lyova Manukyan
- Department of Medical Chemistry Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Artem Sergey Grigoryan
- Department of Pathophysiology Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Lilit Serob Hunanyan
- Department of Medical Chemistry Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Hayk Ashot Harutyunyan
- Science Research Center (SRC), Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Mariam Varos Manukyan
- Science Research Center (SRC), Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Magdalina Mher Melkonyan
- Department of Medical Chemistry Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
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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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Beck Edvardsen J, Hetmann F. Promoting Sleep in the Intensive Care Unit. SAGE Open Nurs 2020; 6:2377960820930209. [PMID: 33415285 PMCID: PMC7774495 DOI: 10.1177/2377960820930209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 04/27/2020] [Accepted: 05/02/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Intensive care nurses face several challenges to facilitating sleep in their
critically ill patients. With its high noise levels, hectic around-the-clock
activity and constant artificial lights, the intensive care environment does
not foster sleep. Intensive care unit patients have significant alterations
in their sleep architecture with frequent awakenings and lighter sleep; up
to 50% of this sleep also occurs during the daytime. Sleep loss increases
the risk of developing delirium (especially in elderly patients) and immune
system impairment, which prolongs healing. The aim of this article was to
develop an evidence-based bundle of nursing care activities that promote
adult intensive care patients’ sleep. Methods A broad search was conducted in PubMed, CINAHL, Cochrane Library, and
McMaster plus using search words and Medical Subject Headings terms, such as
sleep, intensive care unit, intensive care, critical care nursing, sleep
promotion, music, white noise, earplugs, pain relief, absence of pain,
nonpharmacological intervention, and mechanical ventilation. Eight
recommendations emerged from this review: reduce noise, use earplugs and eye
masks, use music, promote a natural circadian rhythm, manage pain, use quiet
time, cluster nursing care activities at night, and optimize ventilator
modes. Conclusion Promoting sleep within this patient population needs to be a higher priority
for intensive care nurses. Sleep should be a focus throughout the day and
night, in order to sustain patients’ natural circadian rhythms. Novel
research in this field could change the strength of these recommendations
and add new recommendations to the bundle.
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Affiliation(s)
- Jorunn Beck Edvardsen
- Department of Postoperative and Critical Care, Division of Emergencies and Critical Care, Oslo University Hospital
| | - Fredrik Hetmann
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University
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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.
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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
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Quality Improvement Initiative to Reduce Nighttime Noise in a Transplantation and Cellular Therapy Unit. Biol Blood Marrow Transplant 2019; 25:1844-1850. [DOI: 10.1016/j.bbmt.2019.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 01/08/2023]
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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.
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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
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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]
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Affiliation(s)
- Andreas Xyrichis
- Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, King's College London, UK
| | - John Wynne
- London College of Communication, University of the Arts London, UK
| | | | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, King's College London, UK
| | - Angus Carlyle
- London College of Communication, University of the Arts London, UK
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Prevalence of Hearing Loss Among Noise-Exposed Workers Within the Health Care and Social Assistance Sector, 2003 to 2012. J Occup Environ Med 2018; 60:350-356. [DOI: 10.1097/jom.0000000000001214] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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12
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Malak Akgün B, Akgün M. Terapötik Ortamda Gürültü Kontrolü. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2017. [DOI: 10.18863/pgy.310834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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.
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Ornelas-Aguirre JM, Zárate-Coronado O, Gaxiola-González F, Neyoy-Sombra V. [Environmental noise levels in 2 intensive care units in a tertiary care centre]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2017; 88:253-260. [PMID: 28385368 DOI: 10.1016/j.acmx.2017.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION The World Health Organisation (WHO) has established a maximum noise level of 40 decibels (dB) for an intensive care unit. The aim of this study was to compare the noise levels in 2 different intensive care units at a tertiary care centre. METHODS Using a cross-sectional design study, an analysis was made of the maximum noise level was within the intensive coronary care unit and intensive care unit using a digital meter. A measurement was made in 4 different points of each room, with 5minute intervals, for a period of 60minutes 7:30, 14:30, and 20:30. The means of the observations were compared with descriptive statistics and Mann-Whitney U. An analysis with Kruskal-Wallis test was performed to the mean noise level. RESULTS The noise observed in the intensive care unit had a mean of 64.77±3.33dB (P=.08), which was similar to that in the intensive coronary care unit, with a mean of 60.20±1.58dB (P=.129). Around 25% or more of the measurements exceeded the level recommended by the WHO by up to 20 points. CONCLUSIONS Noise levels measured in intensive care wards exceed the maximum recommended level for a hospital. It is necessary to design and implement actions for greater participation of health personnel in the reduction of environmental noise.
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Affiliation(s)
- José Manuel Ornelas-Aguirre
- División de Investigación en Salud, Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, Centro Médico Nacional del Noroeste, Instituto Mexicano del Seguro Social, ciudad Obregón, Sonora, México; Departamento de Ciencias de la Salud, Universidad de Sonora, Campus Cajéme, Obregón, Sonora, México.
| | - Olivia Zárate-Coronado
- Dirección de enfermería, Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, Centro Médico Nacional del Noroeste, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| | - Fabiola Gaxiola-González
- Servicio de urgencias y terapia intensiva, Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, Centro Médico Nacional del Noroeste, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
| | - Venigna Neyoy-Sombra
- Servicio de urgencias y terapia intensiva, Hospital de Especialidades No. 2, Unidad Médica de Alta Especialidad, Centro Médico Nacional del Noroeste, Instituto Mexicano del Seguro Social, Obregón, Sonora, México
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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]
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Shield B, Shiers N, Glanville R. The acoustic environment of inpatient hospital wards in the United Kingdom. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2016; 140:2213. [PMID: 27914398 DOI: 10.1121/1.4962276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Many hospital noise surveys have shown that patients are subject to high levels of noise, in excess of current World Health Organization guidelines. Much of the previous research has focused on areas perceived to be noisy, such as intensive care units and operating theatres. This paper presents the results of a comprehensive noise survey of five general inpatient hospital wards in the UK. The survey involved continuous noise monitoring over several days, including identification of noise sources, in 31 locations representing a range of typical patient accommodations including single rooms and multi-bed bays, and nurse stations. The results were consistent with those of previous studies with daytime levels ranging from 50 to 61 dB LAeq and nighttime levels from 41 to 51 dB LAeq. Noise levels were not correlated with room/bay size, with single rooms having some of the highest levels. Overall levels were related to reverberation times and to the numbers of high level noise events. Analysis of noise sources showed that much of the noise could be eliminated or reduced through improved design of equipment and ward layouts. In general, noise levels in wards built since the year 2000 were lower than those in the older buildings.
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Affiliation(s)
- Bridget Shield
- School of Built Environment and Architecture, London South Bank University, London SE1 7JQ, United Kingdom
| | - Nicola Shiers
- School of Built Environment and Architecture, London South Bank University, London SE1 7JQ, United Kingdom
| | - Rosemary Glanville
- School of Built Environment and Architecture, London South Bank University, London SE1 7JQ, United Kingdom
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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.
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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
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Sasso L, Bagnasco A, Aleo G, Catania G, Dell'Agnello D, Currie K, Timmins F. Editorial: Noise on hospital wards - what have we learned? J Clin Nurs 2016; 25:891-3. [PMID: 26868436 DOI: 10.1111/jocn.13200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Loredana Sasso
- Department of Health Sciences; University of Genoa; Genoa Italy
| | | | - Giuseppe Aleo
- Department of Health Sciences; University of Genoa; Genoa Italy
| | | | | | - Kay Currie
- School of Health and Life Sciences; Glasgow Caledonian University; Glasgow UK
| | - Fiona Timmins
- School of Nursing and Midwifery; Trinity College Dublin; Dublin Ireland
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Gudberg C, Johansen-Berg H. Sleep and Motor Learning: Implications for Physical Rehabilitation After Stroke. Front Neurol 2015; 6:241. [PMID: 26635718 PMCID: PMC4656813 DOI: 10.3389/fneur.2015.00241] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 10/30/2015] [Indexed: 12/22/2022] Open
Abstract
Sleep is essential for healthy brain function and plasticity underlying learning and memory. In the context of physical impairment such as following a stroke, sleep may be particularly important for supporting critical recovery of motor function through similar processes of reorganization in the brain. Despite a link between stroke and poor sleep, current approaches to rehabilitative care often neglect the importance of sleep in clinical assessment and treatment. This review assimilates current evidence on the role of sleep in motor learning, with a focus on the implications for physical rehabilitation after stroke. We further outline practical considerations for integrating sleep assessment as a vital part of clinical care.
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Affiliation(s)
- Christel Gudberg
- Oxford Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital , Oxford , UK ; Sleep and Circadian Neuroscience Institute (SCNi), Nuffield Department of Clinical Neurosciences, University of Oxford, Sir William Dunn School of Pathology , Oxford , UK
| | - Heidi Johansen-Berg
- Oxford Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital , Oxford , UK
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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.
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Salzmann-Erikson M, Lagerqvist L, Pousette S. Keep calm and have a good night: nurses' strategies to promote inpatients' sleep in the hospital environment. Scand J Caring Sci 2015; 30:356-64. [DOI: 10.1111/scs.12255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 06/12/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Martin Salzmann-Erikson
- Faculty of Health and Occupational Studies; University of Gävle; Högskolan i Gävle Gävle Sweden
| | - Linda Lagerqvist
- Department of Health and Caring Science; Faculty of Health and Occupational Studies; University of Gävle; Högskolan i Gävle Gävle Sweden
| | - Sandra Pousette
- Department of Health and Caring Science; Faculty of Health and Occupational Studies; University of Gävle; Högskolan i Gävle Gävle Sweden
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Fillary J, Chaplin H, Jones G, Thompson A, Holme A, Wilson P. Noise at night in hospital general wards: a mapping of the literature. ACTA ACUST UNITED AC 2015; 24:536-40. [DOI: 10.12968/bjon.2015.24.10.536] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Julie Fillary
- Senior Research Nurse, Borthwick Diabetes & Research Centre, East and North Herts NHS Trust, Stevenage
| | - Hema Chaplin
- Previously Research Assistant, Centre for Lifespan and Chronic Illness Research, University of Hertfordshire
| | - Gill Jones
- Information Skills Librarian, East and North Herts NHS Trust, Stevenage
| | - Angela Thompson
- Director of Nursing, East and North Herts NHS Trust, Stevenage
| | - Anita Holme
- Lead Research Nurse, Borthwick Diabetes & Research Centre, East and North Herts NHS Trust, Stevenage
| | - Patricia Wilson
- Previously Reader in Patient Experience, University of Hertfordshire
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Park M, Vos P, Vlaskamp BNS, Kohlrausch A, Oldenbeuving AW. The influence of APACHE II score on the average noise level in an intensive care unit: an observational study. BMC Anesthesiol 2015; 15:42. [PMID: 25861240 PMCID: PMC4389973 DOI: 10.1186/s12871-015-0019-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/28/2015] [Indexed: 11/15/2022] Open
Abstract
Background Noise levels in hospitals, especially in intensive care units (ICUs) are known to be high, potentially affecting not only the patients’ well-being but also their clinical outcomes. In an observational study, we made a long-term measurement of noise levels in an ICU, and investigated the influence of various factors on the noise level, including the acute physiology and chronic health evaluation II (APACHE II) score. Methods The average noise level was continuously measured for three months in all (eight) patient rooms in an ICU, while the patient data were also registered, including the APACHE II score. The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events. For the patients with LOS ≥4 days, the average noise levels in the first four days were analyzed, and regression models were established using the stepwise search method based on the Akaike information criterion. Results Features identified in the 24-hour trends (n = 55) agreed well with the daily routine events in the ICU, where regular check-ups raised the 10-minute average noise level by 2~3 dBA from the surrounding values at night, and the staff shift changes consistently increased the noise level by 3~5 dBA. When analyzed in alignment with the patient’s admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient’s recovery. Regression analysis showed that the APACHE II score, room location, gender, day of week and the ICU admission type could explain more than 50 % of the variance in the daily average noise level, LAeq,24h. Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points. Conclusions Patient’s initial health condition is one important factor that influences the acoustic environment in an ICU, which needs to be considered in observational and interventional studies where the noise in healthcare environments is the subject of investigation.
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Affiliation(s)
- Munhum Park
- Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands
| | - Pieter Vos
- Department of Intensive Care Medicine, St. Elisabeth Hospital, P.O. Box 90151, LC Tilburg, 5000 The Netherlands
| | - Björn N S Vlaskamp
- Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands
| | - Armin Kohlrausch
- Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands ; Human-Technology Interaction Group, Technische Universiteit Eindhoven, P.O. Box 513, MB Eindhoven, 5600 The Netherlands
| | - Annemarie W Oldenbeuving
- Department of Intensive Care Medicine, St. Elisabeth Hospital, P.O. Box 90151, LC Tilburg, 5000 The Netherlands
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Abstract
Noise is pervasive in everyday life and can cause both auditory and non-auditory health effects. Noise-induced hearing loss remains highly prevalent in occupational settings, and is increasingly caused by social noise exposure (eg, through personal music players). Our understanding of molecular mechanisms involved in noise-induced hair-cell and nerve damage has substantially increased, and preventive and therapeutic drugs will probably become available within 10 years. Evidence of the non-auditory effects of environmental noise exposure on public health is growing. Observational and experimental studies have shown that noise exposure leads to annoyance, disturbs sleep and causes daytime sleepiness, affects patient outcomes and staff performance in hospitals, increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance in schoolchildren. In this Review, we stress the importance of adequate noise prevention and mitigation strategies for public health.
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Affiliation(s)
- Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
| | - Wolfgang Babisch
- Department of Environmental Hygiene, Federal Environment Agency, Berlin, Germany
| | - Adrian Davis
- Public Health England, Wellington House, Waterloo Road, London, UK; Ear Institute, University College, London, UK
| | - Mark Brink
- D-MTEC Public and Organizational Health, ETH Zurich, Zurich, Switzerland
| | - Charlotte Clark
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Sabine Janssen
- Department of Urban Environment and Safety, TNO (Netherlands Organization for Applied Scientific Research), Delft, Netherlands
| | - Stephen Stansfeld
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and London School of Medicine and Dentistry, Queen Mary University of London, UK
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Hinkulow MB. Evidence to change practice: creating a restful hospital environment for nurses and patients. Arch Psychiatr Nurs 2014; 28:74-5. [PMID: 24506991 DOI: 10.1016/j.apnu.2013.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 09/25/2013] [Indexed: 11/25/2022]
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Development and Validation of Sleep Disturbance Questionnaire in Patients with Acute Coronary Syndrome. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:978580. [PMID: 27382631 PMCID: PMC4897318 DOI: 10.1155/2014/978580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Revised: 07/27/2014] [Accepted: 07/28/2014] [Indexed: 11/17/2022]
Abstract
Background and Objectives. Severe sleep disturbance is a common problem among patients in cardiac care units (CCUs). There are questionnaires to measure sleep disturbances. Therefore, the present study seeks to design a valid and reliable questionnaire to assess sleep disturbance in patients with acute coronary syndrome (ACS) hospitalized in CCUs. Materials and Methods. In the present methodological research, items of the questionnaire were extracted through a systematic review. The validity and reliability of the questionnaires was assessed by face validity, content validity, construct validity, Cronbach's alpha coefficient, and test-retest methods. Results. Factor analysis provided a questionnaire of 23 items on 5 dimensions of sleep disturbance in coronary patients: “sleep onset and continuity disorder,” “disorder in daytime functioning,” “sleep disturbance caused by environmental factors,” “sleep disturbance as a result of cardiac diseases,” and “respiratory disorders during sleep.” Furthermore, test-retest analysis showed a reliability correlation coefficient of r = 0.766 and α Cronbach's reliability (α = 0.855). Conclusion. Sleep disturbance questionnaire for patients with ACS hospitalized in coronary care unit (CCU) was identified in 5 dimensions and assessed for validity and reliability. To control and improve the sleep quality of CCU hospitalized patients, we need to identify and remove predisposing factors.
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Abstracts of the British Society of Audiology annual conference (incorporating the Experimental and Clinical Short papers meetings). Int J Audiol 2013. [DOI: 10.3109/14992027.2013.765042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Valizadeh S, Bagher Hosseini M, Alavi N, Asadollahi M, Kashefimehr S. Assessment of sound levels in a neonatal intensive care unit in tabriz, iran. J Caring Sci 2013; 2:19-26. [PMID: 25276706 DOI: 10.5681/jcs.2013.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 02/26/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION High levels of sound have several negative effects, such as noise-induced hearing loss and delayed growth and development, on premature infants in neonatal intensive care units (NICUs). In order to reduce sound levels, they should first be measured. This study was performed to assess sound levels and determine sources of noise in the NICU of Alzahra Teaching Hospital (Tabriz, Iran). METHODS In a descriptive study, 24 hours in 4 workdays were randomly selected. Equivalent continuous sound level (Leq), sound level that is exceeded only 10% of the time (L10), maximum sound level (Lmax), and peak instantaneous sound pressure level (Lzpeak) were measured by CEL-440 sound level meter (SLM) at 6 fixed locations in the NICU. Data was collected using a questionnaire. SPSS13 was then used for data analysis. RESULTS Mean values of Leq, L10, and Lmax were determined as 63.46 dBA, 65.81 dBA, and 71.30 dBA, respectively. They were all higher than standard levels (Leq < 45 dB, L10 ≤50 dB, and Lmax ≤65 dB). The highest Leq was measured at the time of nurse rounds. Leq was directly correlated with the number of staff members present in the ward. Finally, sources of noise were ordered based on their intensity. CONCLUSION Considering that sound levels were higher than standard levels in our studied NICU, it is necessary to adopt policies to reduce sound.
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Affiliation(s)
- Sousan Valizadeh
- Department of Pediatrics Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Bagher Hosseini
- Department of Pediatrics Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nasrinsadat Alavi
- Department of Pediatrics Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Malihe Asadollahi
- Department of Pediatrics Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Siamak Kashefimehr
- Hospital Manager, Alzahra Teaching Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Kennedy MRC. Sleep as a moderating value in healthcare facility design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2012; 6:122-42. [PMID: 23224847 DOI: 10.1177/193758671200600108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Healthcare design is produced by large design teams with vital input from clients and expert consultants. Throughout the design process, choices are made based on evaluations by all parties; however, some of these evaluations cannot be reduced to a common metric. Many complex interactions defy objective evaluation. It is proposed that jointly agreed-on values can be deployed as moderators in subjective evaluations, allowing design teams to work together more harmoniously. OBJECT Design evidence base for one use-value: sleep. A literature review considers the evidence currently found regarding the value of sleep for hospital inpatients and the actual quality of inpatient sleep. Intrinsic and extrinsic reasons for shortened or poor sleep are reviewed, with an emphasis on environmental considerations. There are many manners in which designers and caregivers are aware that good sleeping conditions can be provided; therefore it is by choice, albeit unwittingly, that poor sleeping conditions have arisen. CONCLUSION The value of sleep to hospital inpatients is very high, even in the short term. Inpatients' sleep is currently not as good as it could or should be. Conflicting views, varied constraints, and requirements might be harmonized and give way to successful innovation if design teams and project stakeholders adopt moderating values as a guide for design evaluations.
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Young J, Macke CJ, Tsoukalas LH. Short-term acoustic forecasting via artificial neural networks for neonatal intensive care units. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2012; 132:3234-3239. [PMID: 23145607 DOI: 10.1121/1.4754556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Noise levels in hospitals, especially neonatal intensive care units (NICUs), have become of great concern for hospital designers. This paper details an artificial neural network (ANN) approach to forecasting the sound loads in NICUs. The ANN is used to learn the relationship between past, present, and future noise levels. By training the ANN with data specific to the location and device used to measure the sound, the ANN is able to produce reasonable predictions of noise levels in the NICU. Best case results show average absolute errors of 5.06 ± 4.04% when used to predict the noise levels one hour ahead, which correspond to 2.53 dBA ± 2.02 dBA. The ANN has the tendency to overpredict during periods of stability and underpredict during large transients. This forecasting algorithm could be of use in any application where prediction and prevention of harmful noise levels are of the utmost concern.
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Affiliation(s)
- Jason Young
- Sonicu LLC, P.O. Box 125, New Palestine, Indiana 46163, USA.
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Haynes PL, Parthasarathy S, Kersh B, Bootzin RR. Examination of insomnia and insomnia treatment in psychiatric inpatients. Int J Ment Health Nurs 2011; 20:130-6. [PMID: 21371228 DOI: 10.1111/j.1447-0349.2010.00711.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Despite the high comorbidity of insomnia with psychiatric illness, few studies have examined insomnia or insomnia treatments in psychiatric inpatients. The present study had two overall goals. First, we sought to describe insomnia symptoms in 76 US veterans hospitalized for a wide-range of psychiatric illnesses. Next, we sought to examine whether participation in one session of group therapy for insomnia was associated with improvement in Insomnia Severity Index (ISI) scores for a subset of these inpatients (n = 19). Data were extracted from the clinical charts of 140 inpatients admitted into the 26-bed psychiatric ward at the New Mexico VA Healthcare System. The majority of the veterans had clinical insomnia in the moderate-to-severe range, and only 18% of the sample reported no clinically-significant insomnia. There was a significant reduction in ISI scores approximately 1 week after attendance at the group therapy session, which appears to be unrelated to the length of hospitalization, but might be related to psychiatric stabilization. This is the first study to examine insomnia symptoms in a mixed, psychiatric inpatient population. Group therapy for insomnia might be a particularly useful treatment option given polypharmacy and substance dependency issues often arising in this population.
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Affiliation(s)
- Patricia L Haynes
- Southern Arizona VA Health Care System, University of Arizona, Department of Psychiatry, Tucson, Arizona 85724-5002, USA.
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Hasfeldt D, Laerkner E, Birkelund R. Noise in the Operating Room—What Do We Know? A Review of the Literature. J Perianesth Nurs 2010; 25:380-6. [DOI: 10.1016/j.jopan.2010.10.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Revised: 09/10/2010] [Accepted: 10/04/2010] [Indexed: 11/16/2022]
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