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Idrees S, Sabaretnam M, Chand G, Mishra A, Rastogi A, Agarwal G. Noise level and surgeon stress during thyroidectomy in an endocrine surgery operating room. Head Neck 2024; 46:37-45. [PMID: 37860889 DOI: 10.1002/hed.27552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/03/2023] [Accepted: 10/08/2023] [Indexed: 10/21/2023] Open
Abstract
INTRODUCTION Noise in the operating room is an ongoing problem that impacts the outcome of any surgery. Noise as a stressor can produce a startling reaction and activate the fight or flight response of the autonomic and endocrine systems. The psychobiology of stress as assessed by salivary cortisol level is a sensitive measure of allostatic load. This study aims to correlate, both subjectively and objectively, the salivary cortisol levels of the surgeon with noise level measurement in an endocrine surgery operating room (OR). MATERIALS AND METHODS A prospective observational study was conducted in the Endocrine surgery OR of a tertiary care center. We recorded the noise from the shifting in of patients in the OR to shifting out using a digital sound level meter. The operating surgeon (S) provided two salivary cortisol samples (normal salivary cortisol <5 nmol/L), one baseline and another after the procedure. The questionnaire for the assessment of distraction during thyroidectomy was filled in by the S at the end of the procedure. Salivary cortisol levels were analyzed using SLV-4635 (formerly SLV-2930) DRG Instruments GmbH German using the ELISA technique. Statistical analysis was performed using SPSS 22.0. RESULTS A total of 37 procedures with 74 salivary cortisol samples and 259 questionnaire responses from S were analyzed. All patients with only benign FNAC were operated upon (64.9% colloid). Mean TSH levels were 3.5 ± 6.7 mIU/L. The majority had a solitary thyroid nodule (STN) (25/37, 67.6%). Nineteen patients (51.3%) underwent open hemithyroidectomy, 10 patients total thyroidectomy, and eight patients endoscopic hemithyroidectomy. The mean noise level in the OR was 70 db. The maximum and minimum noise level in the OR was 90.06 and 51.81 dB, respectively. A total of 74 salivary cortisol samples from the S were collected (baseline and post-noise exposure) and mean cortisol levels were recorded. The surgeon was more significantly affected by surrounding noise, especially during critical phases 3 of surgery, mainly, RLN dissection and parathyroid dissection as recorded by their responses in the questionnaire (p = 0.003). The maximum value of post-operative salivary cortisol of surgeon was recorded as 23. 48 ng/mL and the minimum value recorded was 0.49 ng/mL. The difference in baseline cortisol and post-noise exposure cortisol levels of surgeon was found to be significant (p < 0.001). Maximum and mean noise levels were significantly associated with post-noise exposure salivary cortisol elevation in the surgeon (p = 0.032 and 0.014, respectively). The noise levels during RLN dissection were borderline significant with the post-noise exposure salivary cortisol of the surgeon (p = 0.055). CONCLUSION Our research is the first such study which has been done to assess noise levels and their effect on thyroidectomy using objective salivary cortisol measurement. It challenges the misconstrued notion that visceral surgeries requiring lesser instruments are not associated with noise-related stress. Noise is a major distraction and the effect of long-term effect on the entire surgical team needs to be studied.
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Affiliation(s)
- Sarrah Idrees
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Mayilvaganan Sabaretnam
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Gyan Chand
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Anjali Mishra
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Amit Rastogi
- Department of Anaesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Gaurav Agarwal
- Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Zhang Z, Wu Y, Zhou S, Fu P, Yan H. Effects of Music and White Noise Exposure on the Gut Microbiota, Oxidative Stress, and Immune-Related Gene Expression of Mice. Microorganisms 2023; 11:2272. [PMID: 37764116 PMCID: PMC10536120 DOI: 10.3390/microorganisms11092272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
The microbiota in gastrointestinal tracts is recognized to play a pivotal role in the health of their hosts. Music and noise are prevalent environmental factors in human society and animal production and are reported to impact their welfare and physiological conditions; however, the information on the relationship between the microbiota, physiological status, and sound is limited. This study investigated the impact of music and white noise exposure in mice through 16s rRNA gene sequencing, enzyme assay, and qPCR. The results demonstrate that white noise induced oxidative stress in animals by decreasing serum SOD and GSH-PX activity while increasing LDH activity and MDA levels (p < 0.05). Conversely, no oxidative stress was observed in the music treatment group. The relative gene expression of IFN-γ and IL-1β decreased in the white noise group compared to the music and control groups. The 16s rRNA gene amplicon sequencing revealed that Bacteroidetes, Firmicutes, Verrucomicrobia, and Proteobacteria were dominant among all the groups. Furthermore, the proportion of Firmicutes increased in the music treatment group but decreased in the white noise treatment group compared to the control group. In conclusion, white noise has detrimental impacts on the gut microbiota, antioxidant activity, and immunity of mice, while music is potentially beneficial.
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Affiliation(s)
| | | | | | - Pengcheng Fu
- State Key Laboratory of Marine Resource Utilization in South China Sea, Hainan University, Haikou 570228, China
| | - Hong Yan
- State Key Laboratory of Marine Resource Utilization in South China Sea, Hainan University, Haikou 570228, China
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Farooqi ZUR, Ahmad I, Ditta A, Ilic P, Amin M, Naveed AB, Gulzar A. Types, sources, socioeconomic impacts, and control strategies of environmental noise: a review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:81087-81111. [PMID: 36201075 DOI: 10.1007/s11356-022-23328-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Noise exposure has reached an alarming degree over the years because of rapid growth in the industry, transportation, and urbanization. Therefore, it is a dire need to provide awareness of the sources and mitigation strategies of noise, and to highlight the health, and socio-economic impacts of noise. A few research studies have documented this emerging issue; however, there is no comprehensive document describing all types of noise, their impacts on living organisms, and control strategies. This review article summarizes the sources of noise; their effects on industrial workers, citizens, and animals; and the value of property in noisy areas. The plethora of literature is showing an increased level of noise in various cities of the world, which have various health consequences such as high blood pressure, insomnia, nausea, heart attack, exhaustion, dizziness, headache, and triggered hearing loss. Apart from humans, noise also affects animal habitat, preying, and reproduction ability; increases heart rate and hearing loss to even death and loss in property value; and impairs the hospital environment. Finally, we have discussed the possible strategies to mitigate the noise problem, policy statements, and regulations to be followed, with future research directions based on the identified research gaps.
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Affiliation(s)
- Zia Ur Rahman Farooqi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
- Institute of Biological and Environmental Sciences, School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Iftikhar Ahmad
- Department of Environmental Sciences, COMSATS University Islamabad, Vehari Campus, Vehari, 61100, Pakistan
| | - Allah Ditta
- Department of Environmental Sciences, Shaheed Benazir Bhutto University, Sheringal Dir (U),, Khyber Pakhtunkhwa, 18000, Pakistan.
- School of Biological Sciences, The University of Western Australia, Perth, WA, 6009, Australia.
| | - Predrag Ilic
- PSRI Institute for protection and ecology of the Republic of Srpska, Banja Luka, Vidovdanska 43, 78000, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Muhammad Amin
- Department of Energy Systems Engineering, Seoul National University, Seoul, Republic of Korea
| | - Abdul Basit Naveed
- School of Natural Science, National University of Science and Technology (NUST), Islamabad, 44320, Pakistan
| | - Aadil Gulzar
- Deptartment of Environmental Science, University of Kashmir, Srinagar, J & K, 190006, India
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Stigall-Weikle N, Evans KD, Patterson ES. Cognitive Distractions During Sonographic Procedures: Reducing Noise-Based and Light-Based Interruptions in Hospital Rooms. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2021. [DOI: 10.1177/87564793211064890] [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
Sonographers experience a high cognitive load in hospital-based care. High ambient noise and frequent noise-based interruptions include knocking on the room door, questions from others in the room or through communication technology, alarms, alerts from personal devices, and carts and people passing in the hallway. In addition, other providers turning on the overhead light is distracting for exams that need to be conducted in reduced lighting conditions. This article suggests strategies to improve working conditions for sonographers conducting exams on a patient in the hospital room. Our strategies emerge from human factors methods and principles, which derive from communication principles and theory. These strategies are organized by reducing noise-based and light-based interruptions in the hospital room and hallway, primarily through changes to the built environment and communication technology settings and reducing the use of speech during cognitively challenging time periods through training. Most of the strategies are low-cost and can be implemented within the current built environment and communication technology infrastructure. We anticipate that these strategies could enhance patient outcomes, increase patient satisfaction, improve sonographers’ job satisfaction, protect provider health, and increase procedural efficiency.
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Affiliation(s)
- Nicole Stigall-Weikle
- Laboratory for Investigatory Imaging, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Kevin D. Evans
- Laboratory for Investigatory Imaging, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Emily S. Patterson
- Division of Health Information Management and Systems, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
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Kaewunruen S, Huang J, Haslam J. Insights into noise and vibration stemming from the gym’s heavy lifting. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00802-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Giuliano K, Pozzar R. Achieving Noise Reduction With a Novel Lower Limb External Mechanical Compression System. ERGONOMICS IN DESIGN 2021. [DOI: 10.1177/10648046211016690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Hospitals are one of the noisiest public environments in the United States, and hospital noise is associated with disrupted sleep. This study provides insights into the noise levels produced by three commonly used medical devices for mechanical deep vein thrombosis prophylaxis: the VenaFlow Elite System, the Kendall SCD Compression System, and the ArjoHuntleigh Flowtron. Noise levels produced were compared with a novel device, the RF Health MAC™ system, which was designed to provide improved comfort and noise reduction. Results suggest that future innovation in mechanical deep vein thrombosis prophylaxis should include efforts to reduce noise during operation.
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Husser EK, Fick DM, Boltz M, Shrestha P, Siuta J, Malloy S, Overstreet A, Leslie DL, Ngo L, Jung Y, Inouye SK, Marcantonio ER. Implementing a Rapid, Two-Step Delirium Screening Protocol in Acute Care: Barriers and Facilitators. J Am Geriatr Soc 2021; 69:1349-1356. [PMID: 33474729 DOI: 10.1111/jgs.17026] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND/OBJECTIVES An effective and efficient protocol for delirium identification is needed to improve health outcomes for older adults and reduce healthcare costs. This study describes the barriers and facilitators related to the implementation of the ultra-brief confusion assessment method (UB-CAM), a rapid two-step delirium identification protocol (ultra-brief screen, followed by CAM in positives), field tested with hospitalized older adults (70+). DESIGN A qualitative descriptive design using observational data collection and brief semi-structured interviews. SETTINGS An urban academic medical center and a community teaching hospital. PARTICIPANTS Participants included 50 physician hospitalists, 189 registered nurses, and 83 nursing assistants (NAs). MEASUREMENTS Field researchers guided by a modified multi-level implementation framework, collected observational data as participants administered the UB-CAM (n = 767). Thematic analysis was conducted on five observational categories: structural, organizational, patient, clinician, and innovation. Field notes and brief semi-structured interviews (n = 231) with clinicians, explored the utility, acceptability, and feasibility of the protocol, and supplemented the observations. RESULTS The UB-CAM was generally positively received by all three clinician types. Six themes describe barriers and/or facilitators to implementing the UB-CAM: (1) physical setting and milieu; (2) practice environment; (3) integrating into role; (4) adaptive techniques; (5) patient responses; and (6) systematic assessment. The composition and interaction of the six themes determined if the theme was expressed as a barrier or facilitator, affirming the importance of context when implementing system-level delirium screening. CONCLUSION This is one of the first studies to test a two-step process for delirium identification, and to involve NAs in screening, and the findings demonstrate overall support from clinicians for delirium identification, and describe the need for a multifaceted, contextualized, and systemic approach to implementation and evaluation of delirium screening.
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Affiliation(s)
- Erica K Husser
- The Pennsylvania State University, College of Nursing, University Park, Pennsylvania, USA
| | - Donna M Fick
- The Pennsylvania State University, College of Nursing, University Park, Pennsylvania, USA
| | - Marie Boltz
- The Pennsylvania State University, College of Nursing, University Park, Pennsylvania, USA
| | - Priyanka Shrestha
- The Pennsylvania State University, College of Nursing, University Park, Pennsylvania, USA
| | - Jonathan Siuta
- Mount Nittany Physician Group, Mount Nittany Medical Center, State College, Pennsylvania, USA
| | - Shannon Malloy
- Beth Israel Deaconess Medical Center, Department of General Medicine, Boston, Massachusetts, USA
| | - Abigail Overstreet
- Beth Israel Deaconess Medical Center, Department of General Medicine, Boston, Massachusetts, USA
| | - Douglas L Leslie
- The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA
| | - Long Ngo
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Yoojin Jung
- Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Sharon K Inouye
- Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Edward R Marcantonio
- Divisions of General Medicine and Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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Villard S, Kidd G. Assessing the benefit of acoustic beamforming for listeners with aphasia using modified psychoacoustic methods. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 148:2894. [PMID: 33261373 PMCID: PMC8097716 DOI: 10.1121/10.0002454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 06/12/2023]
Abstract
Acoustic beamforming has been shown to improve identification of target speech in noisy listening environments for individuals with sensorineural hearing loss. This study examined whether beamforming would provide a similar benefit for individuals with aphasia (acquired neurological language impairment). The benefit of beamforming was examined for persons with aphasia (PWA) and age- and hearing-matched controls in both a speech masking condition and a speech-shaped, speech-modulated noise masking condition. Performance was measured when natural spatial cues were provided, as well as when the target speech level was enhanced via a single-channel beamformer. Because typical psychoacoustic methods may present substantial experimental confounds for PWA, clinically guided modifications of experimental procedures were determined individually for each PWA participant. Results indicated that the beamformer provided a significant overall benefit to listeners. On an individual level, both PWA and controls who exhibited poorer performance on the speech masking condition with spatial cues benefited from the beamformer, while those who achieved better performance with spatial cues did not. All participants benefited from the beamformer in the noise masking condition. The findings suggest that a spatially tuned hearing aid may be beneficial for older listeners with relatively mild hearing loss who have difficulty taking advantage of spatial cues.
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Affiliation(s)
- Sarah Villard
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Gerald Kidd
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
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Hughes Driscoll CA, Cleveland M, Gurmu S, Crimmins S, El-Metwally D. Research: Replacing Overhead Paging with Smartphones to Reduce Hospital Noise. Biomed Instrum Technol 2020; 54:251-257. [PMID: 33171501 DOI: 10.2345/0899-8205-54.4.251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hospital noise is associated with adverse effects on patients and staff. Communication through overhead paging is a major contributor to hospital noise. Replacing overhead paging with smartphones through a clinical mobility platform has the potential to reduce transitory noises in the hospital setting, though this result has not been described. The current study evaluated the impact of replacing overhead paging with a smartphone-based clinical mobility platform on transitory noise levels in a labor and delivery unit. Transitory noises were defined as sound levels greater than 10 dB above baseline, as recorded by a sound level meter. Prior to smartphone implementation, 77% of all sound levels at or above 60 dB were generated by overhead paging. Overhead pages occurred at an average rate of 3.17 per hour. Following smartphone implementation, overhead pages were eliminated and transitory noises decreased by two-thirds (P < 0.001). The highest recorded sound level decreased from 76.54 to 57.34 dB following implementation. The percent of sounds that exceeded the thresholds recommended by the Environmental Protection Agency and International Noise Council decreased from 31.2% to 0.2% following implementation (P < 0.001). Replacement of overhead paging with a clinical mobility platform that utilized smartphones was associated with a significant reduction in transitory noise. Clinical mobility implementation, as part of a noise reduction strategy, may be effective in other inpatient settings.
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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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Blustein J, Wallhagen MI, Weinstein BE, Chodosh J. Time to Take Hearing Loss Seriously. Jt Comm J Qual Patient Saf 2019; 46:53-58. [PMID: 31732478 DOI: 10.1016/j.jcjq.2019.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 10/25/2022]
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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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Lim HP, Sanderson P. A comparison of two designs for earcons conveying pulse oximetry information. APPLIED ERGONOMICS 2019; 78:110-119. [PMID: 31046941 DOI: 10.1016/j.apergo.2019.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/20/2018] [Accepted: 01/27/2019] [Indexed: 06/09/2023]
Abstract
We performed a randomised controlled trial comparing two kinds of earcons that could provide intermittent pulse oximetry information about a patient's oxygen saturation (SpO2) and heart rate (HR). Timbre-earcons represented SpO2 levels with different levels of timbre, and pitch-earcons with different levels of pitch. Both kinds of earcons represented HR with tremolo. Participants using pitch-earcons identified SpO2 levels alone, and both SpO2 plus HR levels, significantly better than participants using timbre-earcons: p < .001 in both cases. However, there was no difference between earcon conditions in how effectively HR was identified, p = .422. For both kinds of earcons, identification of SpO2 levels was more compromised by simultaneous changes in HR than identification of HR levels was compromised by simultaneous changes in SpO2, suggesting asymmetric integrality. Overall, pitch-earcons may provide a better intermittent auditory pulse oximetry display than timbre-earcons, especially for clinical contexts when quiet is needed.
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Affiliation(s)
- Hai-Ping Lim
- School of Psychology, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Penelope Sanderson
- School of Psychology, The University of Queensland, St Lucia, QLD, 4072, Australia; School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, QLD, Australia; School of Clinical Medicine, The University of Queensland, St Lucia, QLD, 4072, Australia.
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Zeroth JA, Dahlquist LM, Foxen-Craft EC. The effects of auditory background noise and virtual reality technology on video game distraction analgesia. Scand J Pain 2018; 19:207-217. [DOI: 10.1515/sjpain-2018-0123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/11/2018] [Indexed: 12/12/2022]
Abstract
Abstract
Background and aims
The present study was designed to evaluate the relative efficacy of two video game display modalities – virtual reality (VR) assisted video game distraction, in which the game is presented via a VR head-mounted display (HMD) helmet, versus standard video game distraction, in which the game is projected on a television – and to determine whether environmental context (quiet versus noisy) moderates the relative efficacy of the two display modalities in reducing cold pressor pain in healthy college students.
Methods
Undergraduate students (n=164) were stratified by sex and self-reported video game skill and were randomly assigned to a quiet or a noisy environment. Participants then underwent three cold pressor trials consisting of one baseline followed by two distraction trials differing in display modality (i.e. VR-assisted or standard distraction) in counter-balanced order.
Results
Participants experienced improvement in pain tolerance from baseline to distraction in both display modality conditions (p<0.001, partial η2=0.41), and there was a trend toward greater improvement in pain tolerance from baseline to distraction when using the VR HMD helmet than during standard video game distraction (p=0.057, partial η2=0.02). Participants rated pain as more intense when experienced with concurrent experimental background noise (p=0.047, partial η2=0.02). Pain tolerance was not influenced by the presence or absence of background noise, and there was not a significant interaction between display modality and noise condition. Though exploratory sex analyses demonstrated a significant three-way interaction between noise condition, sex, and display modality on pain intensity (p=0.040, partial η2=0.040), follow-up post-hoc analyses conducted for males and females separately did not reveal significant differences in pain intensity based on the interaction between noise condition and display modality.
Conclusions
As expected, video game distraction both with and without an HMD helmet increased pain tolerance; however, the two display modalities only marginally differed in efficacy within the population under study. The effect of auditory background noise on pain was mixed; while pain tolerance did not vary as a function of the presence or absence of background noise, the addition of noise increased pain intensity ratings. The interaction between participant sex, noise condition, and distraction modality on pain intensity trended toward significance but would require replication in future research.
Implications
Results suggest that video game distraction via HMD helmet may be superior to standard video game distraction for increasing pain tolerance, though further research is required to replicate the trending findings observed in this study. Though it does not appear that background noise significantly impacted the relative efficacy of the two different video game display modalities, the presence of noise does appear to alter the pain response through amplified pain intensity ratings. Further research utilizing more sophisticated VR technology and clinically relevant background auditory stimuli is necessary in order to better understand the impact of these findings in real-world settings and to test the clinical utility of VR technology for pain management relative to standard video game distraction.
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Affiliation(s)
- Julia A. Zeroth
- Department of Psychology , University of Maryland , Baltimore County, 1000 Hilltop Circle , Baltimore, MD 21250 , USA
| | - Lynnda M. Dahlquist
- Department of Psychology , University of Maryland , Baltimore County , Baltimore, MD , USA
| | - Emily C. Foxen-Craft
- Department of Psychology , University of Maryland , Baltimore County , Baltimore, MD , USA
- Department of Pediatrics, C.S. Mott Children’s Hospital , University of Michigan , Ann Arbor, MI , USA
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Abstract
Uncontrolled noise in the hospital setting can have a negative physiological and psychological impact on patients and nurses. To reduce unit noise levels and create a quiet patient and nurse experience, an evidence-based practice project was conducted in 4 progressive care units in a community hospital. The Quiet Time Bundle implementation improved patient satisfaction and patient and nurse perceptions of noise even though the decrease in noise levels may not be discernible.
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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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Baqar M, Arslan M, Abbasi SA, Ashraf U, Khalid A, Zahid H. Noise pollution in the hospital environment of a developing country: A case study of Lahore (Pakistan). ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2017; 73:367-374. [PMID: 28836912 DOI: 10.1080/19338244.2017.1371106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 08/20/2017] [Indexed: 06/07/2023]
Abstract
The present study investigates the noise pollution levels in public- and private-sector hospitals of Lahore. The noise pollution parameters were investigated from 20 public and 10 private hospitals. We observed that the equivalent continuous sound level (Leq) values varied significantly in different departments of the hospitals as well as at different times of the day. The public-sector hospitals had significantly higher noise pollution compared to the private-sector hospitals. The Wilcoxon Mann-Whitney two-sample rank-sum test revealed significant difference between noise levels in intensive care unit (ICU) during morning and in emergency, waiting area, intensive care unit (ICU), and reception during daytimes. However, no significant differences were found for any department during the evening. The Leq values were found to be higher than the international norms (WHO standards) for all hospitals, higher than USEPA for 29 hospitals and higher than local standards for 27 hospitals. Overall, significantly lower sound levels were always observed in private hospitals.
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Affiliation(s)
- Mujtaba Baqar
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
- b Sustainable Development Study Centre , Government College University , Lahore , Pakistan
| | - Muhammad Arslan
- c Geosciences Department , King Fahd University of Petroleum and Minerals , Dhahran , Saudi Arabia
- d Environmental Biotechnology Department, Helmholtz Center for Environmental Research , Leipzig , Germany
| | - Saddam A Abbasi
- e Department of Mathematics, Statistics and Physics , Qatar University , Doha , Qatar
| | - Uzma Ashraf
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
| | - Anam Khalid
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
| | - Hina Zahid
- a College of Earth and Environmental Sciences , University of the Punjab , Lahore , Pakistan
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Albright JD, Seddighi RM, Ng Z, Sun X, Rezac DJ. Effect of environmental noise and music on dexmedetomidine-induced sedation in dogs. PeerJ 2017; 5:e3659. [PMID: 28785527 PMCID: PMC5541919 DOI: 10.7717/peerj.3659] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/16/2017] [Indexed: 12/18/2022] Open
Abstract
Background Previous studies in human patients suggest depth of sedation may be affected by environmental noise or music; however, related data in domestic animals is limited. The objective of the current study was to investigate the effect of noise and music on dexmedetomidine-induced (DM- 10 µg/kg, IM) sedation in 10 dogs. Methods In a crossover design, post-DM injection dogs were immediately subjected to recorded human voices at either 55–60 decibel (dB) (Noise 1) or 80–85 dB (Noise 2); classical music at 45–50 dB (Music); or background noise of 40–45 dB (Control+). Control− included IM saline injection and exposure to 40–45 dB background noise. Sedation was assessed via monitoring spontaneous behavior and accelerometry (delta-g) throughout three 20-min evaluation periods: baseline, noise exposure, and post-treatment. Sedation was further assessed during two restraint tests at 30 min (R1) and 40 min (R2) post-injection. A mixed model for crossover design was used to determine the effect of noise exposure and time on either spontaneous behavior scores or delta-g. The restraint scores were analyzed using a two-way repeated measures ANOVA. Results Spontaneous behavior scores indicated less sedation during Noise 2 compared to Control+ (P = 0.05). R2 restraint scores for all DM treatments except Noise 2 indicated significantly higher sedation than Control− [C+ (P = 0.003), M (P = 0.014) and N1 (P = 0.044)]. Discussion Results suggest that the quality of sedation is negatively impacted by high-intensity noise conditions (80–85 dB), but exposure to music did not improve sedation in this population of research dogs.
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Affiliation(s)
- Julia D Albright
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee-Knoxville, Knoxville, TN, United States of America
| | - Reza M Seddighi
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee-Knoxville, Knoxville, TN, United States of America
| | - Zenithson Ng
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee-Knoxville, Knoxville, TN, United States of America
| | - Xiaocun Sun
- Office of Information Technology, University of Tennessee-Knoxville, Knoxville, TN, United States of America
| | - D J Rezac
- Veterinary & Biomedical Research Center, Inc., Manhattan, KS, United States of America
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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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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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Pope DS, Miller-Klein ET. Acoustic assessment of speech privacy curtains in two nursing units. Noise Health 2016; 18:26-35. [PMID: 26780959 PMCID: PMC4918673 DOI: 10.4103/1463-1741.174377] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hospitals have complex soundscapes that create challenges to patient care. Extraneous noise and high reverberation rates impair speech intelligibility, which leads to raised voices. In an unintended spiral, the increasing noise may result in diminished speech privacy, as people speak loudly to be heard over the din. The products available to improve hospital soundscapes include construction materials that absorb sound (acoustic ceiling tiles, carpet, wall insulation) and reduce reverberation rates. Enhanced privacy curtains are now available and offer potential for a relatively simple way to improve speech privacy and speech intelligibility by absorbing sound at the hospital patient's bedside. Acoustic assessments were performed over 2 days on two nursing units with a similar design in the same hospital. One unit was built with the 1970s' standard hospital construction and the other was newly refurbished (2013) with sound-absorbing features. In addition, we determined the effect of an enhanced privacy curtain versus standard privacy curtains using acoustic measures of speech privacy and speech intelligibility indexes. Privacy curtains provided auditory protection for the patients. In general, that protection was increased by the use of enhanced privacy curtains. On an average, the enhanced curtain improved sound absorption from 20% to 30%; however, there was considerable variability, depending on the configuration of the rooms tested. Enhanced privacy curtains provide measureable improvement to the acoustics of patient rooms but cannot overcome larger acoustic design issues. To shorten reverberation time, additional absorption, and compact and more fragmented nursing unit floor plate shapes should be considered.
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Affiliation(s)
- Diana S Pope
- Department of Nursing Research, VA Portland Health Care System, Portland, Oregon, USA
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Hill JN, LaVela SL. Noise Levels in Patient Rooms and at Nursing Stations at Three VA Medical Centers. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2015; 9:54-63. [DOI: 10.1177/1937586715592635] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To conduct an assessment of sound, dB(A) levels, in two areas of the hospital: patient rooms and nurse stations using sound meters (SMs). Background: The World Health Organization (WHO) recommends sound levels of 35 dB(A) during the day and 30 dB(A) during the night; however, many hospitals exceed these recommended levels. Assessing post-occupancy sound levels enables hospital administrators and healthcare workers to identify whether interventions to improve sound levels are needed. Methods: Sound assessments were conducted at three healthcare facilities in both patient rooms and nursing stations, and we include information on facility characteristics. An Amprobe SM-20A Sound Level Meter was placed for a 24-hr period and recorded decibel levels every 8 min. These sound levels were averaged for each hour for reporting purposes. Averages as well as highest and lowest readings are reported for both daytime (8 a.m.–10 p.m.) and nighttime (10 p.m.–8 a.m.) for each facility. Results: All three sites are considered urban and are classified with the highest complexity level (1a). Average daytime measurements for patient rooms and their corresponding nurses stations were as follows: Site A—63 dB(A)/56 dB(A), Site B—52 dB(A)/55 dB(A), and Site C—42 dB(A)/59 dB(A). Average nighttime measurements for patient rooms and nurses stations were Site A—62 dB(A)/55 dB(A), Site B—48 dB(A)/55 dB(A), and Site C—42 dB(A)/60 dB(A). Conclusion: Our findings, considered independently and collectively, showed that facilities in this study exceeded the WHO-recommended sound levels for patient rooms of 35 dB(A) during daytime and 30 dB(A) during nighttime. Research has reported negative patient outcomes, for example, decreased satisfaction, sleep disturbance, and higher incidence of rehospitalization in patients staying in areas with higher noise levels.
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Affiliation(s)
- Jennifer N. Hill
- Center for Evaluation of Practices and Experiences of Patient-Centered Care (CEPEP), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center of Innovation for Complex Chronic Health Care (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL, USA
| | - Sherri L. LaVela
- Center for Evaluation of Practices and Experiences of Patient-Centered Care (CEPEP), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Department of Veterans Affairs (VA), Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center of Innovation for Complex Chronic Health Care (CINCCH), Edward Hines Jr. VA Hospital, Hines, IL, USA
- Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Kersten N, Backé E. Occupational noise and myocardial infarction: considerations on the interrelation of noise with job demands. Noise Health 2015; 17:116-22. [PMID: 25774615 PMCID: PMC4918664 DOI: 10.4103/1463-1741.153403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The present analysis aims to differentiate the association of noise on myocardial infarction (MI) by job specific demands using International Standard Classification of Occupations (ISCO)-88 codes as a proxy. Data of a German case-control study were supplemented by job descriptions (indicated by ISCO-88). It was examined whether the demands in the various occupational groups modify the effect of noise. Noise and occupational groups are combined to form new exposure categories. Conditional logistic regression models were fitted to identify effects of combined job-noise categories. For the highest noise range (95-124 dB(A)) we found a significant odds-ratio (OR) of 2.18 (confidence interval [CI]0.95 = 1.17-4.05) independent of the profession. Some interesting results were found indicating ISCO groups with possible risk. In men, noticeable effects for the exposure category between 62 dB(A) and 84 dB(A) are calculated in the group of legislators and senior officials (ISCO-group 11; OR=1.93; CI0.95 = 0.50-7.42), the group consisting of life science and health professionals (ISCO-group 22; OR=2.18; CI0.95 = 0.36-13.1), the group of life science and health associate professionals (ISCO-group 32; OR = 2.03; CI0.95 = 0.50-8.24), and the group of “precision, handicraft, printing, and related trades workers” (ISCO-group 73; OR = 2.67; CI0.95 = 0.54-13.0). In the exposure range of 85-94 dB(A), high ORs are calculated for “skilled agricultural, fishery, and forestry workers” (ISCO-group 6; OR = 4.31; CI0.95 = 0.56-33.3). In women, there are high (nonsignificant) ORs in ISCO-group 1 (OR = 2.43; CI0.95 = 0.12-50.0), ISCO-group 2 (OR = 1.80; CI0.95 = 0.31-10.5), and ISCO-group 9 (OR = 2.45; CI0.95 = 0.63-9.51) for a noise exposure between 62 dB(A) and 84 dB(A). When investigating noise at the workplace in relation to cardiovascular diseases it is important to take the specific requirements of a job into account. Thus, work tasks with high health risks can be identified that helps to develop appropriate prevention strategies.
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Affiliation(s)
- Norbert Kersten
- Department of Work and Health, Federal Institute for Occupational Safety and Health, Berlin, Germany
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Adatia S, Law S, Haggerty J. Room for improvement: noise on a maternity ward. BMC Health Serv Res 2014; 14:604. [PMID: 25432130 PMCID: PMC4253989 DOI: 10.1186/s12913-014-0604-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Accepted: 11/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For mothers who have just given birth, the postpartum hospital stay is meant to promote an environment where resting, healing and bonding can take place. New mothers, however, face many interruptions throughout the day including multiple visitors and noise caused by medical equipment, corridor conversations and intercom announcements. This paper argues that disruptions and noise on a maternity ward are detrimental to the healing process for new mothers and their newborns and healthcare decision-makers need to act to improve the environment for these patients. This paper also provides recommendations on how to reduce the noise levels, or at least control the noise on a maternity ward, through the implementation of a daily quiet time. DISCUSSION Hospital disruptions and its negative health effects in particular for new mothers and their children are illustrated in this paper. Hospital noise and interruptions act as a stressor for both new mothers and staff, and can lead to sleep deprivation and detrimental cardiovascular health effects. Sleep deprivation is associated with a number of negative mental and physical health consequences such as decreased immune function, vascular dysfunction and increased sympathetic cardiovascular modulation. Sleep deprivation can also increase the risk of postpartum mental health disorders in new mothers. Some efforts have been made to reduce the disruptions experienced by these patients within a hospital setting. For example, the introduction of a daily quiet time is one way of controlling noise levels and interruptions, however, these have mostly been implemented in intensive care units. Noise and disruptions are a significant problem during postpartum hospital stay. Healthcare institutions are responsible for patient-centered care; a quiet time intervention promises to contribute to a safe, healing environment in hospitals.
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Affiliation(s)
- Safina Adatia
- Department of Family Medicine, McGill University, Montreal, Canada.
| | - Susan Law
- Department of Family Medicine, McGill University, Montreal, Canada.
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montreal, Canada.
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Gazarian PK, Carrier N, Cohen R, Schram H, Shiromani S. A description of nurses' decision-making in managing electrocardiographic monitor alarms. J Clin Nurs 2014; 24:151-9. [PMID: 24813940 DOI: 10.1111/jocn.12625] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2014] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To describe the cues and factors that nurses use in their decision-making when responding to clinical alarms. BACKGROUND Alarms are designed to be very sensitive, and as a result, they are not very specific. Lack of adherence to the practice standards for electrocardiographic monitoring in hospital settings has been observed, resulting in overuse of the electrocardiographic monitoring. Monitoring without consideration of clinical indicators uses scarce healthcare resources and may even produce untoward circumstances because of alarm fatigue. With so many false alarms, alarm fatigue represents a symptom of a larger problem. It cannot be fixed until all of the factors that contribute to its existence have been examined. DESIGN This was a qualitative descriptive study. METHOD This study was conducted at an academic medical centre located in the Northeast United States. Eight participants were enrolled using purposive sampling. Nurses were observed for two three-hour periods. Following each observation, the nurse was interviewed using the critical decision method to describe the cognitive processes related to the alarm activities. Qualitative data from the conducted interviews were analysed via an a priori framework founded in the critical decision method. RESULTS This study reveals information, experience, guidance and decision-making as the four prominent categories contributing to nurses' decision-making in relation to alarm management. Managing technology was a category not identified a priori that emerged in the data analysis. CONCLUSION Nurses revealed a breadth of information needed to adequately identify and interpret monitor alarms, and how they used that information to put the alarms into the particular context of an individual patient's situations. RELEVANCE TO CLINICAL PRACTICE Understanding the cues and factors nurses use when responding to cardiac alarms will guide the development of learning experiences and inform policies to guide practice.
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Affiliation(s)
- Priscilla K Gazarian
- School of Nursing and Health Sciences, Simmons College, Boston, MA, USA; Brigham and Women's Hospital, Center for Nursing Excellence, Boston, MA, USA
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Behavior observation of major noise sources in critical care wards. J Crit Care 2013; 28:1109.e5-1109.e18. [PMID: 23927941 DOI: 10.1016/j.jcrc.2013.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 06/12/2013] [Accepted: 06/16/2013] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to investigate the behavior patterns of typical noise sources in critical care wards and relate their patterns to health care environment in which the sources adapt themselves in several different forms. METHODS An effective observation approach was designed for noise behavior in the critical care environment. Five descriptors have been identified for the behavior observations, namely, interval, frequency, duration, perceived loudness, and location. Both the single-bed and the multiple-bed wards at the selected Critical Care Department were randomly observed for 3 inconsecutive nights, from 11:30 pm to 7:00 am the following morning. The Matlab distribution fitting tool was applied afterward to plot several types of distributions and estimate the corresponding parameters. RESULTS The lognormal distribution was considered the most appropriate statistical distribution for noise behaviors in terms of the interval and duration patterns. The turning of patients by staff was closely related to the increasing occurrences of noises. Among the observed noises, talking was identified with the highest frequency, shortest intervals, and the longest durations, followed by monitor alarms. The perceived loudness of talking in the nighttime wards was classified into 3 levels (raised, normal, and low). Most people engaged in verbal communication in the single-bed wards that occurred around the Entrance Zone, whereas talking in the multiple-bed wards was more likely to be situated in the Staff Work Zone. As expected, more occurrences of noises along with longer duration were observed in multiple-bed wards rather than single-bed wards. "Monitor plus ventilator alarms" was the most commonly observed combination of multiple noises.
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Pope DS, Gallun FJ, Kampel S. Effect of hospital noise on patients' ability to hear, understand, and recall speech. Res Nurs Health 2013; 36:228-41. [DOI: 10.1002/nur.21540] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2013] [Indexed: 11/06/2022]
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Pate W, Charlton M, Wellington C. Measurement and analysis of 8-hour time-weighted average sound pressure levels in a vivarium decontamination facility. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2013; 68:173-179. [PMID: 23566325 DOI: 10.1080/19338244.2012.676104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Occupational noise exposure is a recognized hazard for employees working near equipment and processes that generate high levels of sound pressure. High sound pressure levels have the potential to result in temporary or permanent alteration in hearing perception. The cleaning of cages used to house laboratory research animals is a process that uses equipment capable of generating high sound pressure levels. The purpose of this research study was to assess occupational exposure to sound pressure levels for employees operating cage decontamination equipment. This study reveals the potential for overexposure to hazardous noise as defined by the Occupational Safety and Health Administration (OSHA) permissible exposure limit and consistent surpassing of the OSHA action level. These results emphasize the importance of evaluating equipment and room design when acquiring new cage decontamination equipment in order to minimize employee exposure to potentially hazardous noise pressure levels.
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Affiliation(s)
- William Pate
- Department of Environmental Health and Safety, The University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229, USA.
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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]
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Gum LF, Prideaux D, Sweet L, Greenhill J. From the nurses' station to the health team hub: How can design promote interprofessional collaboration? J Interprof Care 2012; 26:21-7. [DOI: 10.3109/13561820.2011.636157] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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