Delirium Variability is Influenced by the Sound Environment (DEVISE Study): How Changes in the Intensive Care Unit soundscape affect delirium incidence

Sangari, Ayush; Emhardt, Elizabeth A.; Salas, Barbara; Avery, Andrew H.; Freundlich, Robert E.; Fabbri, Daniel; Shotwell, Matthew S.; Schlesinger, Joseph J.

doi:10.1007/s10916-021-01752-5

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…Hospitals are noisy environments and regularly exceed the World Health Organization’s recommended noise levels [ 19 , 20 ]. Noisy clinical environments are associated with sleep disturbance which increases risk of falls but also increases risk of delirium (which in turn increases falls risk) [ 20 , 21 ]. Further, falls with injury are less likely in quieter hospital environments [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of using falls alarms in subacute care: A qualitative study

Considine,

Berry,

Mullen

et al. 2023

PLoS ONE

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Bed and chair alarms have been included in many multifaceted falls prevention interventions. None of the randomised trials of falls alarms as sole interventions have showed significant effect on falls or falls with injury. Further, use of bed and chair alarms did not change patients’ fear of falling, length of hospital stay, functional status, discharge destination or health related quality of life. The aim of this study was to explore nurses’ experiences of using bed and chair alarms. A qualitative descriptive study using semi-structured interviews with a purposive sample of 12 nurses was conducted on a 32-bed Geriatric Evaluation and Management ward in Melbourne, Australia. Participants were interviewed between 27 January and 12 March 2021.Transcribed audio-recordings of interviews were analysed using inductive thematic analysis. NVIVO 12.6 was used to manage the study data. Three major themes and four subthemes were constructed from the data: i) negative impacts of falls alarms (subthemes: noisy technology, imperfect technology), ii) juggling the safety-risk conflict, and iii) negotiating falls alarm use (subthemes: nurse decision making and falls alarm overuse). Nurses’ experience of using falls alarms was predominantly negative and there was tension between falls alarms having limited impact on patient safety and risks associated with their use. Nurses described a need to support nurse decision making related to falls alarms use in practice and policy, and a desire to be empowered to manage falls risk in other ways.

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Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of using falls alarms in subacute care: A qualitative study

Considine,

Berry,

Mullen

et al. 2023

PLoS ONE

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“…However, low agreeableness was detected as one of the risk factors for delirium onset, suggesting that people with low agreeableness are more likely to develop psychotic and behavioural symptoms in delirium due to the cognitive impairment associated with poor engagement for communication. Furthermore, it has been reported that high agreeableness may have promoted a good adjustment to the specific environment, 29 and environmental factors which lead to sleep disturbance may be risk factors for delirium 30,31 . These suggest that inability to adapt to the environment due to low agreeableness may lead to delirium onset via sleep disturbance.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, it has been reported that high agreeableness may have promoted a good adjustment to the specific environment, 29 and environmental factors which lead to sleep disturbance may be risk factors for delirium. 30,31 These suggest that inability to adapt to the environment due to low agreeableness may lead to delirium onset via sleep disturbance. However, the mechanisms underlying the relationship between agreeableness and postoperative delirium onset are not yet understood, and further research is needed.…”

Section: Discussionmentioning

confidence: 99%

Relationship between preoperative anxiety and onset of delirium after cardiovascular surgery in elderly patients: focus on personality and coping process

et al. 2022

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Background Postoperative delirium is associated with increased mortality. Therefore, it is important to manage delirium during the entire perioperative period. Preoperative anxiety is associated with poor prognosis in postoperative patients who have undergone cardiovascular surgery. This study aims to investigate the relationship between preoperative anxiety and onset of delirium after cardiovascular surgery in elderly patients (aged 65 years or older), considering the individual psychological characteristics, such as personality and stress coping skills in response to anxiety, as confounding factors. Methods This prospective study included patients aged >65 years in a preoperative state before undergoing cardiovascular surgery. Subjects were divided into two groups based on whether they experienced postoperative delirium, or not. We compared clinical and demographic factors, preoperative psychiatric and psychological factors, and intraoperative and perioperative physical factors between the control and delirium groups. Multiple imputations were used to account for missing data. Results Out of 168 subjects enrolled in this study, 26 (15.5%) developed postoperative delirium. Univariate analysis showed significant differences in age (P = 0.027), cognitive function (P = 0.007), agreeableness (P = 0.029), and the Acute Physiology and Chronic Health Evaluation‐II (APACHE‐II) score (P = 0.023) between the delirium and control groups. Multiple logistic regression analysis did not identify a significant association between preoperative anxiety and the onset of postoperative delirium. However, age (odds ratio (OR) = 1.114, P = 0.018), agreeableness (OR = 0.555, P = 0.008), and the APACHE‐II score (OR = 1.227, P = 0.008) were identified as risk factors for postoperative delirium. Conclusion Agreeableness, one of the personality traits associated with preoperative anxiety, appears to be involved in the development of postoperative delirium as an independent psychological factor, regardless of age or physical factors.

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“…Hearing impairment is associated with a greater prevalence of psychotic symptoms in both general and psychiatric populations. Moreover, the sound environment in an ICU can affect the odds of delirium incidence in patients, an acute and fluctuating disturbance of consciousness and cognition, which is a risk factor related to mortality in the hospital [15].…”

Section: Noise Effects On Patientsmentioning

confidence: 99%

Surveys on Noise in Some Hospital Wards and Self-Reported Reactions from Staff: A Case Study

Castro

Iarossi

Brambilla³

et al. 2022

Buildings

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Noise in hospital wards adversely affects the physiological processes of both patients and staff and it is a potential risk for communication breakdowns and errors, causing discomfort and problems regarding the healing of patients, as well as stress, fatigue, and annoyance for staff. Several noise sources are present in the wards, such as HVAC systems, alarms, paging, speech, calls, diagnostic equipment, medical devices, and so forth. This paper describes two surveys carried out at an Italian hospital in Rome to investigate the noise in some wards and to collect self-reported assessments from staff about their working environments, even if such assessments were not required for occupational noise exposure evaluation. Self-reported staff evaluations of the working environment quality and the effects of noise on their performances should be investigated. For this purpose, in this study, questionnaires were designed and submitted to staff members. In addition, noise measurements were taken from short-, medium-, and long-term audio recordings processed to determine psychoacoustic parameters, e.g., loudness, sharpness, roughness, and fluctuation strength. Their applications in enclosed spaces can provide additional information on some features of the noise observed in hospital wards, which may influence the perceptions and relevant extra-auditory effects. Even though the results cannot be generalized, they encourage the development of a methodology for noise surveys in hospital wards, including noise measurements and “ad hoc” questionnaires to collect self-reported reactions from exposed staff members.

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Delirium Variability is Influenced by the Sound Environment (DEVISE Study): How Changes in the Intensive Care Unit soundscape affect delirium incidence

Cited by 8 publications

References 39 publications

Nurses’ experiences of using falls alarms in subacute care: A qualitative study

Nurses’ experiences of using falls alarms in subacute care: A qualitative study

Relationship between preoperative anxiety and onset of delirium after cardiovascular surgery in elderly patients: focus on personality and coping process

Surveys on Noise in Some Hospital Wards and Self-Reported Reactions from Staff: A Case Study

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