Noise Reduction in a Pediatric Intensive Care Unit

Monday, 22 July 2013

Dana L. Lerma, MSN, CPNP-AC
Rene Thomas, BSN
Pediatric Intensive Care Unit, Division of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL

Learning Objective 1: The learner will be able to state OSHA noise level guidelines and why it is important for hospitals to attain these levels within inpatient settings.

Learning Objective 2: The learner will compare noise levels within two facilities, and determine if structural and environmental changes were effective in reducing noise levels within the PICU.

Purpose: The purpose of this pre and post analysis study is to examine noise levels within a 42 bed PICU at Children’s Memorial Hospital (CMH), and a 40 bed PICU in the new facility at Lurie Children’s (Lurie’s).  The replication of the study at Lurie’s was to ensure that we continue to stay within the OSHA guidelines of recommended noise levels, and determine if structural design and new equipment decreased noise levels while improving patient and family satisfaction scores regarding noise levels.

Methods: Noise levels were recorded at four nursing stations utilizing dosimeters, a recording device, and the Qualitative Noise Contributor Tool.  This tool allows the data collector to document qualitatively what is being heard during the collection period (alarms, talking, etc.). The noise dosimeter read continuously for 23 hours of the day with data being recorded every 15 seconds. Additionally, qualitative noise was recorded and documented over a two minute period, six times daily. Data collection occurred in two phases, one at each facility, over one week.

Results: The study concluded on December 1st; our preliminary results are as follows:

            CMH- average daytime levels: 49-59 dB; average nighttime levels: 40-54 dB

            Our observations show that majority of the noise were a result of talking, overhead announcements and alarms.  Approximately 15% of comments from satisfaction surveys referred to noise issues.     

            Lurie’s- still pending until numeric data has been statistically analyzed.

            Our observations show that the majority of the noise resulted from talking, alarms, and unit phones. There was a decrease in sharp peaks throughout the day and no negative feedback related to noise.

Conclusion:  In designing the Lurie PICU, environmental, structural and new equipment accommodations were made to decrease noise.  Thus, the cumulation of these changes resulted in a decrease in sharp peaks of noise throughout the day and improved patient satisfaction scores.