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Intensive care units need to find ways to reduce noise

If you've ever spent the night in a hospital bed, you know how noisy a ward can be. There's the noise from your fellow patients, the sounds of doctors and nurses checking in and discussing care options, and all the various beeps and alarms from medical equipment.

All of this can contribute to a poor night's sleep - and that in itself can be a major problem for a patient's wellbeing, especially since sleep is so important in the healing process. The problem is even worse in intensive care units (ICUs), where there are even more noises to worry about and a person's life could hang in the balance.

In fact, recent research has found that the sound levels in hospitals may be even worse than previously thought. The study was carried out at a hospital in Belgium after a spate of patient complaints. It found that noises in an ICU unit were louder than construction equipment - and significantly exceeded guidelines set out by the World Health Organisation (WHO).

Staff running the ICU used a sound level monitor to record decibels continuously for 24 hours beside a bed and at a nursing station.

The bedside monitor recorded average noise levels of 52.8 decibels (dBA) during the night and 54.6 dBA during the day. In total, there were 14 peaks above the 80 dBA recommended limit - this included one that registered 101.1 dBA. That's equivalent to the sound of a pneumatic drill - a piece of equipment that requires users to wear hearing protection.

The WHO recommends that hospital wards should have an average sound of below 35 dBA and 40 dBA at night.

At the nursing station, average noise levels were 52.6 dBA at night and 53.9 dBA during the day, with a maximum sound peak of 90.6 dBA.

Commenting on the findings, Dr Eveline Claes from Jess Ziekenhuis hospital in Hasselt noted that the sound levels in her ICU "clearly exceed" recommendations, but also believes that other hospitals would have a similar problem with noise.

"Those elevated sound levels, as well as frequent sound level peaks, can be responsible for the subjective feeling of noise pollution experienced by patients, doctors and nurses," she explained.

What can be done?

Dealing with noise in a hospital environment can be a complicated task because many of the sounds cannot be avoided. Dr Claes explained that alarms, staff activity and moving equipment are all essential parts of the environment.

"We need the alarms to warn us about emergencies. Various programmes of staff education, task scheduling, equipment repositioning and alarm threshold review have not lowered the sound levels to within WHO-recommended levels," she said.

She explained that one practical solution could be handing out ear defender devices for patients, and suggested that there may be "opportunities in the future to modulate alerts through the use of smart alarm systems and to develop equipment that produces less noise".

Hospitals dealing with high levels of noise may also want to look into how better acoustic insulation could soften sounds and reduce ambient noise levels for patients.

The report's authors will be presenting their findings at the European Society for Anaesthesiology's annual meeting in London.


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