Noise. It is present in almost every aspect of our lives. From the traffic in the streets, to the fan that provides us white noise in the background to sleep, noise exists. Unfortunately, like stress, too much of it can have a negative impact on a person’s health and rest. Some sounds we do like to hear, such as birds chirping, signaling spring in Vermont, but what about sounds in a hospital?

Many of us get admitted to hospitals when we are too sick to take care of ourselves at home. We expect exceptional care from physicians and nurses and, of course, to rest in order to help our bodies heal. We understand that some noises in a hospital are necessary for care; however, others simply aren’t.

The Sounds of a Hospital

Many organizations, including the UVM Medical Center, have high tech equipment, which greatly assists in the delivery of care to our patients, but can also be noisy. Sometimes, healthcare providers are the source of the noise as we interact and communicate with our patients and other health team members.

Another factor is visits from families and friends during visiting hours. It is difficult when one’s roommate is trying to rest in the opposite bed. Yet, we need to be cognizant of noise in patient care areas as sounds can be magnified and misinterpreted, increasing agitation and even confusion for some patients.

We become accustomed to the noise; our patients are not.

The Research on Noise, Quiet, and Healing

Research has shown that noise plays a negative role in healing and that decreasing noise in patient care areas aids in healing processes and helps facilitate speedier recoveries for patients. Patients are able to heal, sleep better and recover more quickly when able to rest.  A quieter environment can also help decrease burnout for hospital staff.

Studies show that patients are more likely to develop negative side effects from a noisy hospital, such as sleep disturbances, elevated blood pressure and heart rate, and increased use of pain medications.

Noise can also increase annoyance levels for staff. One study indicated noise, such as talking inside and outside patient rooms, is the most common source of noise as well as visitors’ voices, TVs, and behaviors of other patients.

Research concluded that best practices to eliminate noise from talking included staff education about noise reduction, public indicators such  as sound monitors, a quiet time protocol, and lower cost environmental fixes, such as fixing noisy doors and squeaky wheels. Lastly, by introducing scripting with routine monitoring, patients’ perception of quietness increased and the perception of noise decreased.

How We Address Noise at the UVM Medical Center

We introduced the “Culture of Quiet” Organizational initiative. The Nursing Professional Governance Patient and Family Experience Global council continued this work.  After convening a small task force of nurses and assessing current quiet strategies, we introduced the following tactics:

  • Many hospital units have designated ‘quiet hours’ with automatically dimming of lights at quiet hour intervals.
  • Signage is visible in most patient care areas to help keep patients, family, and visitors aware. Throughout the hospital, you will see signs with a relaxing pair of Adirondack chairs and the sun setting with details on when a unit has quiet hours.
  • Many semi-private rooms have windows in doors, so doors can be closed allowing for patient rest.
  • We offer headphones for TVs and earplugs to help minimize sounds.
  • In-patient kits contain a sleeping mask and other comfort items that can be provided at time of admission. Each kit contains a card and explains, ‘the best healing occurs in a quiet environment.’
  • New education material is available for staff, patients and visitors-just ask to review the next time visiting.
  • Some units offer white noise machines, others have this built in.
  • Noisy equipment such as wheels and doors can be tagged and replaced.
  • Our facility and distribution staff have changed their cleaning and supply delivery schedules to accommodate patient care.
  • Healthcare teams within the hospital are focusing efforts to cluster patient care to minimize interruptions to provide restful moments.

How you can help us.

We ask patients and visitors to hold us accountable when sounds are too loud. We want our community to alert us when noise levels are high and we will do what we can to minimize sound. In turn, we ask that all members of the healthcare team, patients, family, and friends be aware to keep voices soft, cell phones on vibrate, and hold each other accountable for these are the times of the day when our patients take pause to rest and positively impact their healing.

Everyone should feel comfortable speaking up and letting a health team member know to lower his or her voice. Many of us are not aware of how our voices carry.

When we work collaboratively together, we can commit to keeping a quiet, restful environment for patients to heal.

Karen Fargnoli-Munn, RN, is a nurse educator in Central Programs for Nursing Education and Professional Development at the UVM Medical Center. She will complete her two-year term as a member of the Nursing Professional Governance: Patient and Family Experience Global council in November.  Continuing the “Culture of Quiet” work is one of three bodies of work given to her team to complete. She is excited  to see this reach the finish line!

Laura Lang, RN, is a nurse educator in Central Programs for Nursing Education and Professional Development at the UVM Medical Center. She is also LNA Program coordinator. Her interest in and work within the Culture of Quiet task force started last year when she worked per diem on inpatient pediatrics and recognized the importance of a quiet healing environment on both patients and staff members wellbeing.

 

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