Effects of intensive care unit noise on patients: a study on coronary artery bypass graft surgery patients.

AIMS AND OBJECTIVES The aim of this study was to measure the noise levels in specific locations of an intensive care unit and determine the disturbance levels of patients owing to noise. BACKGROUND Studies have shown that hospital noise is a potential stressor for patients. Noise levels measured in the intensive care unit are mostly far beyond the recommended standards for hospitals, and generally measured around 60-70 dB (A). Although there are a few studies on noise levels in the intensive care unit, no study could be found that compares 24-hour intensive care unit noise measurement data at several locations of intensive care unit. METHODS The study was conducted with 35 coronary artery bypass graft surgery patients. The intensive care unit noise level was measured by using Bruel & Kjaer 2144 Model Frequency Analyzer next to the bed of each patient. A patient's disturbance owing to the intensive care unit noise was questioned. RESULTS Noise levels ranged between 49 and 89 dB (A) with a mean of 65 dB (A). Peak noise levels were measured as high as 89 dB (A). The noise levels measured at different locations in the intensive care unit did not differ significantly. Noises created by other patients, those who were admitted from emergency room and operating room into intensive care unit, monitor alarms, conversations among staff were the most disturbing noise sources for patients. CONCLUSION The patients who were located in the bed which was closer to the nurses' station were more affected by the intensive care unit noise than other patients. Having a previous intensive care unit experience also affected the patients' disturbance levels owing to noise. RELEVANCE TO CLINICAL PRACTICE Nurses are in key positions where they can identify physical, psychological and social stressors that affect patients during their hospital stay. Staff education, planned nursing activities and proper design of intensive care unit may help combat this overlooked problem.

[1]  R. Snyder-Halpern The effect of critical care unit noise on patient sleep cycles. , 1985, CCQ. Critical care quarterly.

[2]  R. Millman,et al.  Adverse environmental conditions in the respiratory and medical ICU settings. , 1994, Chest.

[3]  A. McIntosh Sleep deprivation in critically ill patients. , 1989, Nursing.

[4]  Personal and environmental predictors of patient disturbance due to hospital noise. , 1985, The Journal of applied psychology.

[5]  Richard S. Lazarus,et al.  Emotions and adaptation: Conceptual and empirical relations. , 1968 .

[6]  D. Fontaine,et al.  Designing Humanistic Critical Care Environments , 2001, Critical care nursing quarterly.

[7]  R. Millman,et al.  Identification and modification of environmental noise in an ICU setting. , 1998, Chest.

[8]  M Topf,et al.  Noise-induced stress as a predictor of burnout in critical care nurses. , 1988, Heart & lung : the journal of critical care.

[9]  N. Woods,et al.  Noise stimuli in the acute care area. , 1974, Nursing research.

[10]  C. Tsiou,et al.  Noise sources and levels in the evgenidion hospital intensive care unit , 1998, Intensive Care Medicine.

[11]  M. Williams Physical environment of the intensive care unit and elderly patients , 1989, Critical care nursing quarterly.

[12]  J. F. Thompson,et al.  Noise Pollution in the Operating Theatre , 1990 .

[13]  S Russell,et al.  An exploratory study of patients' perceptions, memories and experiences of an intensive care unit. , 1999, Journal of advanced nursing.

[14]  B. Walder,et al.  Effects of guidelines implementation in a surgical intensive care unit to control nighttime light and noise levels , 2000, Critical care medicine.

[15]  M. Topf A framework for research on aversive physical aspects of the environment. , 1984, Research in nursing & health.

[16]  M Topf,et al.  Noise-induced stress in hospital patients: coping and nonauditory health outcomes. , 1985, Journal of human stress.

[17]  Aitken Rj Quantitative noise analysis in a modern hospital. , 1982 .

[18]  M. Dyson Intensive care unit psychosis, the therapeutic nurse-patient relationship and the influence of the intensive care setting: analyses of interrelating factors. , 1999, Journal of clinical nursing.

[19]  David J. Oborne,et al.  The Physical environment at work , 1983 .

[20]  M. Cornock Stress and the intensive care patient: perceptions of patients and nurses. , 1998, Journal of advanced nursing.

[21]  S A Falk,et al.  Hospital noise--levels and potential health hazards. , 1973, The New England journal of medicine.

[22]  H Dudley,et al.  Perceived noise in surgical wards and an intensive care area: an objective analysis. , 1977, British medical journal.

[23]  Shirlynn Spacapan,et al.  Effects and aftereffects of stressor expectations. , 1983 .

[24]  L. Sands,et al.  The Role of Postoperative Analgesia in Delirium and Cognitive Decline in Elderly Patients: A Systematic Review , 2006, Anesthesia and analgesia.

[25]  M Topf,et al.  Hospital noise pollution: an environmental stress model to guide research and clinical interventions. , 2000, Journal of advanced nursing.

[26]  B A Hilton Noise in acute patient care areas , 1985, Research in nursing & health.

[27]  W. Spotnitz,et al.  Interventions to reduce decibel levels on patient care units. , 1998, The American surgeon.

[28]  R. J. Aitken Quantitative noise analysis in a modern hospital. , 1982, Archives of environmental health.

[29]  B. Garvin,et al.  The effect of environmental sound and communication on CCU patients' heart rate and blood pressure. , 1993, Research in nursing & health.

[30]  R. Elliott,et al.  Verbal communication: what do critical care nurses say to their unconscious or sedated patients? , 1999, Journal of advanced nursing.

[31]  B. Hilton Noise in acute patient care areas , 1985, Research in nursing & health.