Effects of intensive care unit ambient sounds on healthcare professionals: results of an online survey and noise exposure in an experimental setting

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Abstract

Background

Noise levels on intensive care units (ICUs) are typically elevated. While many studies reported negative effects of ICU ambient sounds on patients, only few investigated noise as a factor to influence well-being or performance in healthcare professionals.

Methods

An online survey in the German-speaking part of Switzerland was conducted to assess how ICU soundscapes are subjectively perceived by healthcare professionals. The questionnaire was answered by 348 participants. Additionally, effects of noise on working memory performance were evaluated in an experimental noise exposure setting. Twenty-six healthcare professionals and 27 healthy controls performed a 2-back object-location task while being exposed to either ICU or pink noise.

Results

Survey results demonstrate that a majority of participants was aware of heightened noise levels. Participants reported that mostly well-being, performance, and attention could be reduced, along with subjective annoyance and fatigue by ICU ambient sounds. Although no significant effects of noise exposure on working memory performance was observed, self-assessments revealed significantly higher stress levels, increased annoyance and distraction ratings as well as decreased confidence in performance after ICU-noise exposure.

Conclusion

Subjective assessments indicate that heightened noise levels on ICUs induce annoyance, with heightened stress levels, impaired well-being, and reduced performance being potential consequences. Empirical evidence with objective and physiological measures is warranted.

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Most cited references 33

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Introducing the Open Affective Standardized Image Set (OASIS).

Benedek Kurdi, Shayn Lozano, Mahzarin R. Banaji (2016)

We introduce the Open Affective Standardized Image Set (OASIS), an open-access online stimulus set containing 900 color images depicting a broad spectrum of themes, including humans, animals, objects, and scenes, along with normative ratings on two affective dimensions-valence (i.e., the degree of positive or negative affective response that the image evokes) and arousal (i.e., the intensity of the affective response that the image evokes). The OASIS images were collected from online sources, and valence and arousal ratings were obtained in an online study (total N = 822). The valence and arousal ratings covered much of the circumplex space and were highly reliable and consistent across gender groups. OASIS has four advantages: (a) the stimulus set contains a large number of images in four categories; (b) the data were collected in 2015, and thus OASIS features more current images and reflects more current ratings of valence and arousal than do existing stimulus sets; (c) the OASIS database affords users the ability to interactively explore images by category and ratings; and, most critically, (d) OASIS allows for free use of the images in online and offline research studies, as they are not subject to the copyright restrictions that apply to the International Affective Picture System. The OASIS images, along with normative valence and arousal ratings, are available for download from www.benedekkurdi.com/#oasis or https://db.tt/yYTZYCga .

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Noise effects on human performance: a meta-analytic synthesis.

S Szalma, Jeremy Hancock (2011)

Noise is a pervasive and influential source of stress. Whether through the acute effects of impulse noise or the chronic influence of prolonged exposure, the challenge of noise confronts many who must accomplish vital performance duties in its presence. Although noise has diffuse effects, which are shared in common with many other chronic forms of stress, it also exerts its own specific influences on various forms of cognitive and motor response. We present a quantitative evaluation of these influences so that their harmful effects can be mitigated, their beneficial effects exploited, and any residual effects incorporated and synthesized into selection, training, and design strategies to facilitate human performance capacities. Predictions of single and joint moderator effects were made on the basis of major theories of noise and performance, specifically those explanations based on arousal, masking, or cognitive-resource mechanisms. These predictions were tested through moderator analyses of effects as a function of task type, performance measure, noise type and schedule, and the intensity and duration of exposure. Observed outcome effects (797 effect sizes derived from 242 studies) varied as a function of each of these moderators. Collective findings identified continuous versus intermittent noise, noise type, and type of task as the major distinguishing characteristics that moderated response. Mixed evidence was obtained for the traditional arousal and masking explanations for noise effects. The overall pattern of findings was most consistent with the maximal adaptability theory, a mental-resource-based explanation of stress and performance variation.

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An investigation of sound levels on intensive care units with reference to the WHO guidelines

Julie L Darbyshire, J. Duncan Young (2013)

Introduction Patients in intensive care units (ICUs) suffer from sleep deprivation arising from nursing interventions and ambient noise. This may exacerbate confusion and ICU-related delirium. The World Health Organization (WHO) suggests that average hospital sound levels should not exceed 35 dB with a maximum of 40 dB overnight. We monitored five ICUs to check compliance with these guidelines. Methods Sound levels were recorded in five adult ICUs in the UK. Two sound level monitors recorded concurrently for 24 hours at the ICU central stations and adjacent to patients. Sample values to determine levels generated by equipment and external noise were also recorded in an empty ICU side room. Results Average sound levels always exceeded 45 dBA and for 50% of the time exceeded between 52 and 59 dBA in individual ICUs. There was diurnal variation with values decreasing after evening handovers to an overnight average minimum of 51 dBA at 4 AM. Peaks above 85 dBA occurred at all sites, up to 16 times per hour overnight and more frequently during the day. WHO guidelines on sound levels could be only achieved in a side room by switching all equipment off. Conclusion All ICUs had sound levels greater than WHO recommendations, but the WHO recommended levels are so low they are not achievable in an ICU. Levels adjacent to patients are higher than those recorded at central stations. Unit-wide noise reduction programmes or mechanical means of isolating patients from ambient noise, such as earplugs, should be considered.

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Author and article information

Contributors

Tobias Nef:

ORCID: http://orcid.org/0000-0002-8069-9450

tobias.nef@artorg.unibe.ch

Journal

Journal ID (nlm-ta): Intensive Care Med Exp

Journal ID (iso-abbrev): Intensive Care Med Exp

Title: Intensive Care Medicine Experimental

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2197-425X

Publication date (Electronic): 23 July 2020

Publication date PMC-release: 23 July 2020

Publication date Collection: December 2020

Volume: 8

Electronic Location Identifier: 34

Affiliations

[1 ]GRID grid.5734.5, ISNI 0000 0001 0726 5157, Gerontechnology & Rehabilitation Group, , University of Bern, ; Murtenstrasse 50, CH-3008 Bern, Switzerland

[2 ]GRID grid.5734.5, ISNI 0000 0001 0726 5157, Department of Intensive Care Medicine, University Hospital Bern (Inselspital), , University of Bern, ; CH-3010 Bern, Switzerland

[3 ]GRID grid.5734.5, ISNI 0000 0001 0726 5157, Hearing Research Laboratory, , University of Bern, ; Murtenstrasse 50, CH-3008 Bern, Switzerland

[4 ]GRID grid.5734.5, ISNI 0000 0001 0726 5157, Department of Neurology, University Neurorehabilitation, University Hospital Bern (Inselspital), , University of Bern, ; Freiburgstrasse, CH-3010 Bern, Switzerland

[5 ]GRID grid.5734.5, ISNI 0000 0001 0726 5157, ARTORG Center for Biomedical Engineering Research, , University of Bern, ; Murtenstrasse 50, CH-3008 Bern, Switzerland

Author information

Tobias Nef http://orcid.org/0000-0002-8069-9450

Article

Publisher ID: 321

DOI: 10.1186/s40635-020-00321-3

PMC ID: 7376325

PubMed ID: 32705428

SO-VID: aeb0f32d-0369-4e8f-b199-ef985f39b855

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 11 January 2020

Date accepted : 3 July 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100009068, Universität Bern;

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Keywords: intensive care unit,noise,healthcare professionals,working memory,annoyance,performance

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Keywords: intensive care unit, noise, healthcare professionals, working memory, annoyance, performance

Effects of intensive care unit ambient sounds on healthcare professionals: results of an online survey and noise exposure in an experimental setting

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Pediatric Pulse: Advancing Neonatal and Child Health

Most cited references 33

Introducing the Open Affective Standardized Image Set (OASIS).

Noise effects on human performance: a meta-analytic synthesis.

An investigation of sound levels on intensive care units with reference to the WHO guidelines

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