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Bergez L, Jourdain G, Ayachi A, De Luca D. Noise Produced by Various Respiratory Support Techniques During Neonatal Transportation: A Simulation Study. Respir Care 2024; 69:1161-1164. [PMID: 38744477 PMCID: PMC11349590 DOI: 10.4187/respcare.11859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Affiliation(s)
- Lea Bergez
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France
| | - Gilles Jourdain
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France
| | - Azzedine Ayachi
- Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France
| | - Daniele De Luca
- Dr De Luca is affiliated with Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France; and Physiopathology and Therapeutic Innovation Unit, INSERM U999, Paris Saclay University, Paris, France
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Tronstad O, Zangerl B, Patterson S, Flaws D, Yerkovich S, Szollosi I, White N, Garcia-Hansen V, Leonard FR, Weger BD, Gachon F, Brain D, Lavana J, Hodgson C, Fraser JF. The effect of an improved ICU physical environment on outcomes and post-ICU recovery-a protocol. Trials 2024; 25:376. [PMID: 38863018 PMCID: PMC11167845 DOI: 10.1186/s13063-024-08222-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 06/03/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Intensive care medicine continues to improve, with advances in technology and care provision leading to improved patient survival. However, this has not been matched by similar advances in ICU bedspace design. Environmental factors including excessive noise, suboptimal lighting, and lack of natural lights and views can adversely impact staff wellbeing and short- and long-term patient outcomes. The personal, social, and economic costs associated with this are potentially large. The ICU of the Future project was conceived to address these issues. This is a mixed-method project, aiming to improve the ICU bedspace environment and assess impact on patient outcomes. Two innovative and adaptive ICU bedspaces capable of being individualised to patients' personal and changing needs were co-designed and implemented. The aim of this study is to evaluate the effect of an improved ICU bedspace environment on patient outcomes and operational impact. METHODS This is a prospective multi-component, mixed methods study including a randomised controlled trial. Over a 2-year study period, the two upgraded bedspaces will serve as intervention beds, while the remaining 25 bedspaces in the study ICU function as control beds. Study components encompass (1) an objective environmental assessment; (2) a qualitative investigation of the ICU environment and its impact from the perspective of patients, families, and staff; (3) sleep investigations; (4) circadian rhythm investigations; (5) delirium measurements; (6) assessment of medium-term patient outcomes; and (7) a health economic evaluation. DISCUSSION Despite growing evidence of the negative impact the ICU environment can have on patient recovery, this is an area of critical care medicine that is understudied and commonly not considered when ICUs are being designed. This study will provide new information on how an improved ICU environment impact holistic patient recovery and outcomes, potentially influencing ICU design worldwide. TRIAL REGISTRATION ACTRN12623000541606. Registered on May 22, 2023. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385845&isReview=true .
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Affiliation(s)
- Oystein Tronstad
- Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Rode Road, Chermside, Brisbane, Qld, 4032, Australia.
- Faculty of Medicine, University of Queensland, Brisbane, Australia.
- Physiotherapy Department, The Prince Charles Hospital, Brisbane, Australia.
| | - Barbara Zangerl
- Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Rode Road, Chermside, Brisbane, Qld, 4032, Australia
| | - Sue Patterson
- Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Rode Road, Chermside, Brisbane, Qld, 4032, Australia
- School of Dentistry, University of Queensland, Brisbane, Australia
| | - Dylan Flaws
- Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Rode Road, Chermside, Brisbane, Qld, 4032, Australia
- Department of Mental Health, Metro North Mental Health, Caboolture Hospital, Caboolture, Australia
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Stephanie Yerkovich
- Menzies School of Health Research and Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Irene Szollosi
- Sleep Disorders Centre, The Prince Charles Hospital, Brisbane, Australia
| | - Nicole White
- Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Rode Road, Chermside, Brisbane, Qld, 4032, Australia
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Veronica Garcia-Hansen
- School of Architecture and Built Environment, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia
| | - Francisca Rodriguez Leonard
- School of Architecture and Built Environment, Faculty of Engineering, Queensland University of Technology, Brisbane, Australia
| | - Benjamin D Weger
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Frédéric Gachon
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - David Brain
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Jayshree Lavana
- Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Carol Hodgson
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Division of Clinical Trial and Cohort Studies, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Physiotherapy Department, Alfred Hospital, Melbourne, Australia
| | - John F Fraser
- Critical Care Research Group, The Prince Charles Hospital, Level 3 Clinical Sciences Building, Rode Road, Chermside, Brisbane, Qld, 4032, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Australia
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Dwairi TAT, Hassan EA, Beshay BN, Attia AKN. Actual versus perceived noise levels among critical care nurses and their related adverse effects: A cross-sectional study. Nurs Crit Care 2024. [PMID: 38813946 DOI: 10.1111/nicc.13095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Critical care nurses should help in reducing noise to improve the well-being of patients and health care providers. AIM/S To measure actual noise levels in intensive care units, identify nurses' perceived irritation levels of noise sources and examine the impact of noise on nurses' work performance and well-being. STUDY DESIGN This cross-sectional study was conducted from January to April 2023 at a teaching hospital's six intensive care units. It involved three phases: mapping locations for noise measurement, actual noise measurements in decibels and a cross-sectional survey to identify nurses' perceptions and the adverse effects of noise. Actual noise was measured between patients' beds, nursing stations and beside 16 noise sources for 7 days 24 h a day. For nurse perceptions, the mean of perceived irritation levels by a Likert scale for each noise source was calculated to present perceived noise levels. Ranking of noise sources according to the actual measured and perceived irritation by nurses was done based on mean values. Curve estimation regression test was used to predict the relationship between actual and perceived noise and stepwise multiple linear regression identified factors associated with noise adverse effects. RESULTS The mean noise level in the intensive care units was 65.55 dB. Nurses perceived mechanical ventilator alarms as the most irritating noise. However, the mean noise measurements showed that conversations among colleagues were the primary source of noise. There was no significant predictive relationship between the actual and perceived noise. Nurses reported feeling distressed, irritable, fatigued and less productive due to noise. CONCLUSIONS There was a discrepancy between actual and perceived noise levels by nurses. Perceived noise levels had more impact on nurses than actual noise. RELEVANCE TO CLINICAL PRACTICE By incorporating both objective measurements and subjective perceptions into efforts aimed at reducing noise, health care providers can create quieter intensive care units.
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Affiliation(s)
| | - Eman Arafa Hassan
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Bassem Nashaat Beshay
- Critical Care Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amal Kadry Nicola Attia
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Salameh B, Abdallah J, Alkubati SA, ALBashtawy M. Alarm fatigue and perceived stress among critical care nurses in the intensive care units: Palestinian perspectives. BMC Nurs 2024; 23:261. [PMID: 38654236 PMCID: PMC11036661 DOI: 10.1186/s12912-024-01897-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/28/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE The frequency of alarms generated by monitors and other electro-medical devices is undeniably valuable but can simultaneously escalate the workload for healthcare professionals, potentially subjecting intensive care unit nurses to alarm fatigue. The aim of this study is to investigate alarm fatigue and stress levels among critical care nursing personnel. Additionally, the study aims to assess predictors for both alarm fatigue and perceived stress. METHODOLOGY A descriptive cross-sectional study recruited 187 Intensive Care Unit (ICU) nurses from hospitals located in the northern and central regions of the West Bank, Palestine. Data were gathered through online surveys due to logistic concerns using the Alarm Fatigue Scale and the Perceived Stress Scale. The research was conducted between November 2023 and January 2024. RESULTS The mean overall alarm fatigue score was 23.36 (SD = 5.57) out of 44. The study showed that 62.6% of the participating ICU nurses experience average to high degree of alarm fatigue, while 69.5% experience average to high levels of perceived stress. A significant positive Pearson correlation was found between stress and alarm fatigue (0.40, P < 0.01). Important predictors of alarm fatigue include perceived stress, nurse-to-patient ratio, gender, and years of experience, while important predictors of perceived stress include alarm fatigue, type of working shift and hospital unit. CONCLUSION Alarm fatigue can compromise the timely intervention required to prevent adverse outcomes by causing delayed responses or missed critical alarm, which can have major ramifications for patient safety. Addressing stress is crucial for mitigating alarm fatigue and fostering a supportive work environment to ensure optimal patient care. Consequently, exploring strategies to alleviate the negative impacts of alarm fatigue on critical care nurses' stress merits further investigation in future research studies.
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Affiliation(s)
- Basma Salameh
- Faculty of Nursing, Arab American University, Jenin, Palestine.
| | - Jihad Abdallah
- Department of Animal Production, An-Najah National University,Nablus, Jenin, Palestine
| | - Sameer A Alkubati
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia
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Alkubati SA, Alsaqri SH, Alrubaiee GG, Almoliky MA, Alqalah TAH, Pasay-An E, Alrasheeday AM, Elsayed SM. Levels and Factors of Nurses' Alarm Fatigue in Critical Care Settings in Saudi Arabia: A Multicenter Cross-Sectional Study. J Multidiscip Healthc 2024; 17:793-803. [PMID: 38410522 PMCID: PMC10896094 DOI: 10.2147/jmdh.s452933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
Background A continuous and high frequency of alarms from monitoring and treatment devices can lead to nurses' sensory exhaustion and alarm fatigue in critical care settings. Aim The purpose of this study was to evaluate the level of alarm fatigue and determine the relationship between nurses' sociodemographic and work-related factors and the level of alarm fatigue in critical care settings in Hail City, Saudi Arabia. Methods Between May and July 2023, 298 nurses who worked in the emergency, intensive care, and critical care units of all the public hospitals in Hail City participated in a cross-sectional survey. Sociodemographic and work-related sheet and the Nurses' Alarm Fatigue Questionnaire were used to collect data. Results The total mean score of alarm fatigue was 26.38±8.30 out of 44. The highest score was observed for the item "I pay more attention to the alarms in certain", while the lowest score were observed for the items "I turn off the alarms at the beginning of every shift" with mean scores of 2.51 and 1.61, respectively. Nurses who were males, older than 30 years and Saudi citizens had significantly higher mean scores of alarm fatigue than their counterparts. In addition, significantly higher mean scores of alarm fatigue were noticed for nurses experienced for 10 years or more and who had regular morning shifts. Multiple linear regression showed that male (p=0.014), age (p=0.012), and Saudi nationality (p <0.029) were the independent factors affecting the level of fatigue alarm among nurses. Conclusion Nurses working in critical care settings at hospitals in Hail city are exposed to average levels of alarm fatigue, which can be influenced by sex, age, nationality, and experience of nurses. Therefore, it is imperative to manage alarm fatigue in critical care units by considering work-related and personality-related factors to ensure patient safety.
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Affiliation(s)
- Sameer A Alkubati
- Department of Medical Surgical Nursing, University of Hail, Hail, Saudi Arabia
| | | | - Gamil G Alrubaiee
- Department of Community Health, University of Hail, Hail, Saudi Arabia
| | | | | | - Eddieson Pasay-An
- Fundamental of Nursing Department, King Khalid University, Abha, Saudi Arabia
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Quan L, Xu S, Xu H, Chen F, Wu S, Zhu J, Liu S, Su T. Depression, anxiety, lower sleep quality and social support in square cabin hospitals during Shanghai's COVID-19 lockdown, China. Front Psychiatry 2024; 15:1339774. [PMID: 38374973 PMCID: PMC10875048 DOI: 10.3389/fpsyt.2024.1339774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives To investigate and compare the associated factors of depression, anxiety, and other psychological differences between patients with Corona Virus Disease 2019 quarantined in square cabin hospitals (SCH) and isolation wards (IW) in China. Methods Cluster sampling method was performed during Shanghai's Two-Month Lockdown in 2022. Hospital Anxiety and Depression Scale Depression subscale (HADS-D), 7-tiem Generalized Anxiety Disorder Scale (GAD-7), Pittsburgh sleep quality index (PSQI), and Perceived Social Support Scale (PSSS) were used to investigate psychological differences. Results The HADS-D and GAD-7 scores of SCH patients were significantly higher than those in IW (p < 0.001; p = 0.0295). Sleep latency (SCH-IW = -3.76, p < 0.001), sleep duration (SCH-IW = -2.22, p < 0.05), habitual sleep efficiency (SCH-IW = -4.11, p < 0.001), sleep disturbance (SCH-IW = -3.59, p < 0.001) and use of sleep medication (SCH-IW = -5.18, p < 0.001) of SCH patients were significantly worse. Depression was the main emotional problem of quarantined patients. Patients in SCH had lower social support. Sleep disorders and the lowest oxygen saturation ≤ 93% were risk factors for depression, while social support and child status were protective factors. Myalgia and constipation were risk factors for anxiety, while marital status was the protective factor. Conclusion Patients quarantined in SCH had higher risks of depression and anxiety, lower sleep quality and social support. Somatic discomfort and sleep disorders exacerbated depression and anxiety, which could be ameliorated by social support and taken into consideration in future SCH construction.
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Affiliation(s)
- Li Quan
- Department of Cardiology, Shanghai Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China
| | - Shuyu Xu
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Hao Xu
- Department of Infectious Diseases, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Feng Chen
- Department of Cardiology, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Shengyong Wu
- Department of Military Health Statistics, Naval Medical University, Shanghai, China
| | - Jiaqi Zhu
- Department of Cardiology, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Suxuan Liu
- Department of Cardiology, the First Affiliated Hospital (Changhai Hospital) of Naval Medical University, Shanghai, China
| | - Tong Su
- Faculty of Psychology, Naval Medical University, Shanghai, China
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Ismail A, Imam A, Raguini M, Hassan D, Ali A, Alkhotani A. Impact of Quiet Time on Psychological Outcomes of Neonatal Intensive Care Unit Nurses in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e50307. [PMID: 38205456 PMCID: PMC10777254 DOI: 10.7759/cureus.50307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Although quiet time is implemented in neonatal intensive care units (NICUs) for the benefit of infants, it may also positively impact the psychological outcomes of healthcare professionals. Several studies have examined the impact of quiet-time implementation on patients; however, there is a paucity of research assessing its impact on the psychological outcomes of NICU nurses, particularly in Saudi Arabia. OBJECTIVE AND METHODS This study aimed to assess the impact of quiet time on the psychological outcomes (stress, anxiety, and depression) of NICU nurses in Jeddah, Saudi Arabia. A cross-sectional design was used for this study. A total of 87 NICU nurses from two hospitals participated in this study. One group did not practice quiet time, while the second group did. A questionnaire survey assessed participants' demographic characteristics, and their depression, anxiety, and stress were assessed using the depression, anxiety, and stress scale-21 (DASS-21). The data were analyzed for frequency, percentage, mean, and standard deviation (SD). Bivariate analysis, independent t-tests, and one-way analysis of variance were used to test the differences between variables and groups. Pearson's correlation coefficient (r) was used to analyze the relationships between continuous variables and perceived stress, anxiety, and depression. RESULTS A substantial number of NICU nurses perceived stress, anxiety, and depression; however, there were no significant differences in perceived stress, anxiety, and depression between the nurses who worked in NICUs that applied quiet time and NICUs that did not (P ≤ 0.05). CONCLUSION This study found no statistically significant relationship between quiet-time implementation and perceived stress, anxiety, or depression among NICU nurses. Further research with a larger sample size or increased quiet-time implementation may be required.
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Affiliation(s)
- Ahmad Ismail
- Neonatal Intensive Care, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Ashwag Imam
- Neonatal Intensive Care, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Minerva Raguini
- Neonatal Intensive Care, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Dina Hassan
- Neonatal Intensive Care, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Aziza Ali
- Neonatal Intensive Care, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Abdulaziz Alkhotani
- Pediatrics, Umm Al-Qura University, Makkah, SAU
- Pediatrics, Dr. Soliman Fakeeh Hospital, Jeddah, SAU
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Sangari A, Bingham MA, Cummins M, Sood A, Tong A, Purcell P, Schlesinger JJ. A Spatiotemporal and Multisensory Approach to Designing Wearable Clinical ICU Alarms. J Med Syst 2023; 47:105. [PMID: 37847469 DOI: 10.1007/s10916-023-01997-2] [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: 04/11/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023]
Abstract
In health care, auditory alarms are an important aspect of an informatics system that monitors patients and alerts clinicians attending to multiple concurrent tasks. However, the volume, design, and pervasiveness of existing Intensive Care Unit (ICU) alarms can make it difficult to quickly distinguish their meaning and importance. In this study, we evaluated the effectiveness of two design approaches not yet explored in a smartwatch-based alarm system designed for ICU use: (1) using audiovisual spatial colocalization and (2) adding haptic (i.e., touch) information. We compared the performance of 30 study participants using ICU smartwatch alarms containing auditory icons in two implementations of the audio modality: colocalized with the visual cue on the smartwatch's low-quality speaker versus delivered from a higher quality speaker located two feet away from participants (like a stationary alarm bay situated near patients in the ICU). Additionally, we compared participant performance using alarms with two sensory modalities (visual and audio) against alarms with three sensory modalities (adding haptic cues). Participants were 10.1% (0.24s) faster at responding to alarms when auditory information was delivered from the smartwatch instead of the higher quality external speaker. Meanwhile, adding haptic information to alarms improved response times to alarms by 12.2% (0.23s) and response times on their primary task by 10.3% (0.08s). Participants rated learnability and ease of use higher for alarms with haptic information. These small but statistically significant improvements demonstrate that audiovisual colocalization and multisensory alarm design can improve user response times.
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Affiliation(s)
- Ayush Sangari
- Renaissance School of Medicine, Stony Brook University, 100 Nicolls Rd, Stony Brook, NY, 11790, USA.
| | - Molly A Bingham
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Mabel Cummins
- Department of Neuroscience, Vanderbilt University, Nashville, TN, USA
| | - Aditya Sood
- Long Island Jewish Medical Center, New Hyde Park, New York, USA
| | - Anqy Tong
- Department of Neuroscience, Vanderbilt University, Nashville, TN, USA
| | | | - Joseph J Schlesinger
- Division of Critical Care Medicine, Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
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