Noise in the critical care environment

Introduction

The subject of excessive noise levels within critical care is not new and has been identified on numerous occasions in the literature. Research illustrates the detrimental effect of noise on patients both physically and psychologically. Our interest in this field stemmed from Fundamentals of Care audits which described noise as being too high and disturbing for patients.

Methods

The extent of the problem was initially explored by undertaking an audit of noise using an on-the-spot soundmeter. This showed that noise levels were in excess of the World Health Organisation recommendations for a patient care environment [1]. This confirmed the need to address the subject of noise within our critical care unit. Noise levels were then investigated further using a Soundlog device. This enabled us to measure noise levels continuously over multiple 24-hour periods. The device measures the noise level every second and then records the average measurement every 5 minutes. Noise levels were audited over a 6-week period in a variety of locations in an effort to gain an accurate assessment of noise levels. In doing this, patterns and themes in levels of noise could be identified and analysed.

Results

The audit showed that noise levels were consistently between 52 and 65 dB over a 24-hour period, which is above the WHO guidance of 35 dB and 40 dB limit.

Conclusions

The current noise levels within our unit exceed the recommendations so action needs to be taken to address this. It is a busy unit with some environmental noise origins but also a high density of staff and relatives, so with this in mind we are developing a project plan to enable us to explore the current levels of noise and its sources, identify those sources that are avoidable or open to modification and enable staff to consider their role and responsibility in relation to noise reduction. By considering the issue of noise and developing strategies that result in sustainable reductions in noise levels, we are aiming to improve the patients' experience of their critical care stay. We anticipate that there will be both practical and behavioural solutions to issues that arise, some of which can be addressed by quick-fix solutions while others will require longer term work.