Noise Reduction in an Intensive Care Unit: Implementation of Quiet Time and Noise-Reduction Strategies

Abstract

Background: Excessive noise is a significant problem for patients in intensive care units (ICUs) and is associated with significant psychological effects and the potential to affect patient outcomes. The noise level in our coronary care intensive unit of a cardiac hospital was found to be approximately 80 dB, which exceeded the international recommended level of 35 dB. We sought to review the causes of this excess noise and the effects of an implementation of quiet time and a noise-reduction bundle in the ICU.Methods: A quality improvement initiative was undertaken to solve the noise issue. A multi-disciplinary team was formed and a number of changes were tested. We used a model for improvement, and the changes were tested using small Plan-Do-Study-Act cycles. Two blocks of quiet time (3-4 pm and 2-4 am) were designated as quiet times during which the lights were dimmed, noise-reduction strategies in the form of a bundle were implemented, and procedures were minimized. In addition, educational material and information were disseminated to physicians, nurses, physical therapists, and other potential individuals who might be affected by the changes that were implemented. Quantitative baseline data was collected using sound meter readings three times a day. Qualitative feedback was collected through staff and patient surveys.Results: During quiet hours, the noise level averaged 22 dB—a decrease from 85 dB. One-hundred patients were surveyed and asked for their feedback concerning quiet time: approximately 97% of them were satisfied with the results.Conclusions: It is possible to reduce noise levels in ICUs by implementing simple and effective measures. This reduction has a significant effect on patient satisfaction, and, in addition, promotes healing.