Sustainable reduction in sound levels on intensive care units through noise management - an implementation study
Abstract Background The noise levels in intensive care units usually exceed the recommended limits in (inter)national recommendations. Such noise levels can affect both the recovery of intensive care patients and the performance of staff. The aim of this study was to reduce ward-based noise levels i...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12913-024-12059-9 |
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| author | Sandra Witek Claudia Schmoor Fabian Montigel Birgit Grotejohann Sven Ziegler |
| author_facet | Sandra Witek Claudia Schmoor Fabian Montigel Birgit Grotejohann Sven Ziegler |
| author_sort | Sandra Witek |
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| description | Abstract Background The noise levels in intensive care units usually exceed the recommended limits in (inter)national recommendations. Such noise levels can affect both the recovery of intensive care patients and the performance of staff. The aim of this study was to reduce ward-based noise levels in three intensive care units (anesthesiological, neurological, and neonatological). Methods The implementation of a setting-specific intervention bundle consisting of (a) ward-specific guide to noise management, (b) further noise reduction and prevention measures and (c) the use of “noise traffic lights” was evaluated in an implementation study with a pre-post design. Our primary endpoint was changes in sound level (equivalent continuous sound pressure (LAeq)) 12 weeks after the intervention, and the secondary endpoint was sound level (LAeq), peak sound pressure and maximum sound level at different time points, including changes at 24-week follow-up. Results After the intervention phase, we observed a significant overall reduction in the sound level of 0.77 decibels (A-weighted) (dB (A)), 95%-CI [0.06, 1.49], p = 0.034 with post-intervention measurements of LAeq1h 56.43 dB (A) compared to pre-intervention measurements of 57.21 dB (A). The difference was particularly large (2.21 dB (A) [p < 0.0001] in one of the three intensive care units. After adjusting our analysis for the intensity of nursing workload, the sound level reduction was smaller. Comparisons of LAeq1h between measurement times during the daytime periods showed a post-interventional difference of 58.28 dB(A) to 58.84 dB(A) baseline during the day of 0.57 dB(A), 95%-CI [-0.07, 1.21], p = 0.08 and at night of 53.36 dB(A) post-interventionally to 54.48 dB(A) baseline a difference of 1.11 dB(A) 95%-CI [0.19, 2.04], p = 0.02. In follow-up, baseline sound levels became realigned and we noted a rise in sound level of 0.81 dB (A) [p = 0.01]. Conclusions Our implementation study indicates that a bundle of interventions can reduce noise levels in intensive care units, although the clinical relevance of the measured effect must be questioned. Sufficient resources and a participatory approach using an implementation framework should therefore be employed to manage sustainable noise abatement. Trial registration German Clinical Trials Register (DRKS): trial registration number: DRKS00025835; Date of registration: 12.08.2021. |
| format | Article |
| id | doaj-art-39401ac159fc4313872f657214442f92 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Health Services Research |
| spelling | doaj-art-39401ac159fc4313872f657214442f922025-01-05T12:12:29ZengBMCBMC Health Services Research1472-69632025-01-0125111610.1186/s12913-024-12059-9Sustainable reduction in sound levels on intensive care units through noise management - an implementation studySandra Witek0Claudia Schmoor1Fabian Montigel2Birgit Grotejohann3Sven Ziegler4Center of Implementing Nursing Care Innovations Freiburg, Nursing Direction, Medical Center - University of FreiburgClinical Trials Unit, Faculty of Medicine and Medical Center - University of FreiburgCenter of Implementing Nursing Care Innovations Freiburg, Nursing Direction, Medical Center - University of FreiburgClinical Trials Unit, Faculty of Medicine and Medical Center - University of FreiburgCenter of Implementing Nursing Care Innovations Freiburg, Nursing Direction, Medical Center - University of FreiburgAbstract Background The noise levels in intensive care units usually exceed the recommended limits in (inter)national recommendations. Such noise levels can affect both the recovery of intensive care patients and the performance of staff. The aim of this study was to reduce ward-based noise levels in three intensive care units (anesthesiological, neurological, and neonatological). Methods The implementation of a setting-specific intervention bundle consisting of (a) ward-specific guide to noise management, (b) further noise reduction and prevention measures and (c) the use of “noise traffic lights” was evaluated in an implementation study with a pre-post design. Our primary endpoint was changes in sound level (equivalent continuous sound pressure (LAeq)) 12 weeks after the intervention, and the secondary endpoint was sound level (LAeq), peak sound pressure and maximum sound level at different time points, including changes at 24-week follow-up. Results After the intervention phase, we observed a significant overall reduction in the sound level of 0.77 decibels (A-weighted) (dB (A)), 95%-CI [0.06, 1.49], p = 0.034 with post-intervention measurements of LAeq1h 56.43 dB (A) compared to pre-intervention measurements of 57.21 dB (A). The difference was particularly large (2.21 dB (A) [p < 0.0001] in one of the three intensive care units. After adjusting our analysis for the intensity of nursing workload, the sound level reduction was smaller. Comparisons of LAeq1h between measurement times during the daytime periods showed a post-interventional difference of 58.28 dB(A) to 58.84 dB(A) baseline during the day of 0.57 dB(A), 95%-CI [-0.07, 1.21], p = 0.08 and at night of 53.36 dB(A) post-interventionally to 54.48 dB(A) baseline a difference of 1.11 dB(A) 95%-CI [0.19, 2.04], p = 0.02. In follow-up, baseline sound levels became realigned and we noted a rise in sound level of 0.81 dB (A) [p = 0.01]. Conclusions Our implementation study indicates that a bundle of interventions can reduce noise levels in intensive care units, although the clinical relevance of the measured effect must be questioned. Sufficient resources and a participatory approach using an implementation framework should therefore be employed to manage sustainable noise abatement. Trial registration German Clinical Trials Register (DRKS): trial registration number: DRKS00025835; Date of registration: 12.08.2021.https://doi.org/10.1186/s12913-024-12059-9NoiseIntensive care unitsImplementation scienceInterventionSoundNoise management |
| spellingShingle | Sandra Witek Claudia Schmoor Fabian Montigel Birgit Grotejohann Sven Ziegler Sustainable reduction in sound levels on intensive care units through noise management - an implementation study BMC Health Services Research Noise Intensive care units Implementation science Intervention Sound Noise management |
| title | Sustainable reduction in sound levels on intensive care units through noise management - an implementation study |
| title_full | Sustainable reduction in sound levels on intensive care units through noise management - an implementation study |
| title_fullStr | Sustainable reduction in sound levels on intensive care units through noise management - an implementation study |
| title_full_unstemmed | Sustainable reduction in sound levels on intensive care units through noise management - an implementation study |
| title_short | Sustainable reduction in sound levels on intensive care units through noise management - an implementation study |
| title_sort | sustainable reduction in sound levels on intensive care units through noise management an implementation study |
| topic | Noise Intensive care units Implementation science Intervention Sound Noise management |
| url | https://doi.org/10.1186/s12913-024-12059-9 |
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