DOI: 10.1097/01.ccm.0000458353.75053.e2

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Issn Print: 0090-3493

Publication Date: 2014/12/01


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856: EFFECT OF AN OVERNIGHT “QUIET TIME” PROGRAM ON AMBIENT SOUND LEVELS IN THE SURGICAL ICU

Christopher Tainter; Alexander Levine; David Stahl; Arielle Butterly; Sadeq Quraishi; Jarone Lee

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Author Information: Massachusetts General Hospital, Boston, MA

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Excerpt

Learning Objectives: For hospitals, the World Health Organization (WHO) recommends that mean baseline sound levels should not exceed 30 dB, and that peaks should be maintained below 40 dB. While noise is associated with sleep disturbance and delirium in patients, evidence to support mitigating strategies is limited. Our goal was to determine whether designated “quiet times” are associated with lower ambient noise levels overnight in the ICU.
Methods: We compared noise levels between two surgical ICUs, with similar staffing and patient populations. SICU 1 had a designated “quiet time” (11pm – 5am) in effect for one year prior to the start of the study, consisting of turning down hallway lights, encouraging staff to minimize conversations in care areas, and shifting routine procedures (e.g. X-rays) to “non-quiet” times. SICU 2 served as a control. Paired observational measurements were obtained using a digital sound meter at four consistent locations on each unit at similar times during both day and night shifts. Each data recording included the highest and lowest sound levels during two consecutive 30-second intervals.
Results: 328 observations were assessed (168 in SICU 1 and 160 in SICU 2). During “quiet times,” there were no differences between the two units with respect to minimum sound (50±4 dB vs 51±6, p=0.73) or maximum sound (66±8 dB vs 63±10 dB, p=0.17) levels. During “non-quiet” times there was no difference in minimum sound levels (53±4 dB vs 53±6 dB, p=0.77), but there was significant difference in maximum sound levels (68±1 dB vs 64±8 dB, p<0.01). Unit census did not correlate with sound level (r2=0.03, 0.1).
Conclusions: Our results suggest that a “quiet time” intervention is not associated with lower ambient noise levels during night shifts, and may be associated with higher peak noise levels during “non-quiet” times. Since ambient noise levels remained above WHO recommendations at all times in both units, future efforts should look to characterize factors contributing to ambient noise in the surgical ICU.
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