Nurses at the Mayo Clinic's Saint Marys Hospital, Rochester, Minn., found that when you ask for the patient's perspective, you may literally get an earful. After hearing patients complain about interrupted sleep, RNs in the hospital's thoracic unit launched a study to monitor nighttime patient room noise levels. Their data, based on firsthand experiences--some nurses volunteered to sleep in patient rooms--and recorded decibel readings, showed that the clatter of staff during a shift change, the beeps and drones of life-saving equipment, ringing telephones and typical hospital building noises were a real barrier to patient rest and recovery.
"We were surprised at our findings," says Cheryl Cmiel, R.N., one of the authors of "Noise Control: A Nursing Team's Approach to Sleep Promotion," which was published in the February issue of the American Journal of Nursing. "We hadn't thought of the noises associated with things like putting charts in holders or the pneumatic tube system."
According to the Mayo study, noises generated by staff during shift changes measured at 113 decibels--louder than a jackhammer--while bedside monitor alarms and hallway phones measured near or in excess of 80 decibels, which is as loud as heavy truck traffic.
The findings led Cmiel and other staff to implement a number of changes in their unit, including putting foam rubber padding on patient charts and on pneumatic tube canisters to help muffle the noise they make and replacing loud rolling paper towel dispensers mounted next to hallway sinks with nearly soundless folded towel holders.The study findings also propelled some interdepartmental changes that benefit patients, Cmiel says. The thoracic unit launched a six-month trial to eliminate one of the biggest patient disruptors--X-rays taken in the middle of the night.
The Mayo study spurred other hospital administrators to study noise levels in their facilities. Tom Lee, vice president of administrative services at Avera St. Luke's Hospital, Aberdeen, S.D., decided to see how his hospital compared after being alerted to the Mayo study by a local newspaper reporter. So he took a decimeter and measured noise levels at the nurses' stations, hallways, elevators and on the medical floor, one of the hospital's busiest. While Mayo's loudest reading--113 decibels--came during shift change, Avera St. Luke's highest reading of 108 decibels was recorded during helicopter takeoff. "I thought there was something wrong with our decimeter," Lee says. "I'm surprised [Mayo] got the results they did." He concedes his hospital's carpeted hallways may contribute greatly to the lower noise level, but the real key is the hospital's ongoing attention to noise issues. "We constantly work on it," Lee says.
Patients at Saint Marys have been pleased with the changes to reduce noise. Of 422 patient satisfaction surveys sampled by the study authors, 90 patients responded to a noise and sleep question and of those, 66.5 percent of the responses were positive. These results are a credit to Saint Marys' commitment to employee satisfaction, Cmiel says. "We're focused on empowering individual staff members. Our approach is that our patients will be more satisfied if our nurses are satisfied."
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