Reduction of sound levels in the intermediate care unit; a quasi-experimental time-series design study

IF 4.9 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2024-08-24 DOI:10.1016/j.iccn.2024.103810

Vreman Jeanette , Lanting Cris , Frenzel Tim , van der Hoeven Johannes G. , Lemson Joris , van den Boogaard Mark

{"title":"Reduction of sound levels in the intermediate care unit; a quasi-experimental time-series design study","authors":"Vreman Jeanette , Lanting Cris , Frenzel Tim , van der Hoeven Johannes G. , Lemson Joris , van den Boogaard Mark","doi":"10.1016/j.iccn.2024.103810","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to assess the effectiveness of an architectural redesign and a multicomponent intervention bundle on noise reduction to enhance workplace safety.</p></div><div><h3>Methods/Design</h3><p>Quasi-experimental study with a time-series and intensified intervention design conducted in an intermediate care unit. Two interventions were sequential introduced: the installation of a partition wall in the medication preparation room (architectural redesign) and the implementation of an a bundle. Effects on outcomes were evaluated comparing baseline, after architectural redesign (period-1) and after implementation of the bundle (period-2).</p></div><div><h3>Setting</h3><p>Intermediate care unit.</p></div><div><h3>Main Outcome Measures</h3><p>A-weighted sound levels (LAeq), alarms/day/bed, annoyance ratings (numeric rating scale 0–10) and number of distractions of nurses during the medication preparation process.</p></div><div><h3>Results</h3><p>LAeq baseline vs period-1, decreased in the medication preparation area from 56.8 (±5.0) to 53.7 (±7.2) dBA (p < 0.001) and in the nursing station from 56.8 (±5.0) to 54.3 (±4.0) dBA (p < 0.001). During period-2, further noise reduction was minimal to absent. Distractions decreased from 58 % during baseline to 45 % (p < 0.001) during period-1, with no further reduction during period-2.</p><p>The median [IQR] number of alarms/day/bed increased from 263 [IQR 193–320] during baseline to 394 [IQR 258–474] during period-1 (p < 0.001), then decreased to 303 [IQR 264–370] (p < 0.05) during period-2. Median annoyance ratings decreased from baseline 3.0 [IQR 2.0–6.0] to 2.0 [IQR 1.0–3.0] (p < 0.001) during period-2.</p></div><div><h3>Conclusion</h3><p>An architectural redesign resulted in a significant, clinically relevant decrease in sound levels along with a notable reduction in distractions. The multicomponent bundle lowered alarms and annoyance ratings; however, its effectiveness on other outcomes seems less persuasive.</p></div><div><h3>Implications for Clinical Practice</h3><p>Architectural redesign seems to be effective in controlling environmental noise.</p><p>Architectural redesign results in a decrease in nurses’ distractions during the medication preparation process.</p><p>The effect of an intervention bundle is, despite a positive effect on alarms and perceived annoyance, still insufficiently clear.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"85 ","pages":"Article 103810"},"PeriodicalIF":4.9000,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0964339724001952/pdfft?md5=0e5e34d486e324822281099896dc75ff&pid=1-s2.0-S0964339724001952-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0964339724001952","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

This study aimed to assess the effectiveness of an architectural redesign and a multicomponent intervention bundle on noise reduction to enhance workplace safety.

Methods/Design

Quasi-experimental study with a time-series and intensified intervention design conducted in an intermediate care unit. Two interventions were sequential introduced: the installation of a partition wall in the medication preparation room (architectural redesign) and the implementation of an a bundle. Effects on outcomes were evaluated comparing baseline, after architectural redesign (period-1) and after implementation of the bundle (period-2).

Setting

Intermediate care unit.

Main Outcome Measures

A-weighted sound levels (LAeq), alarms/day/bed, annoyance ratings (numeric rating scale 0–10) and number of distractions of nurses during the medication preparation process.

Results

LAeq baseline vs period-1, decreased in the medication preparation area from 56.8 (±5.0) to 53.7 (±7.2) dBA (p < 0.001) and in the nursing station from 56.8 (±5.0) to 54.3 (±4.0) dBA (p < 0.001). During period-2, further noise reduction was minimal to absent. Distractions decreased from 58 % during baseline to 45 % (p < 0.001) during period-1, with no further reduction during period-2.

The median [IQR] number of alarms/day/bed increased from 263 [IQR 193–320] during baseline to 394 [IQR 258–474] during period-1 (p < 0.001), then decreased to 303 [IQR 264–370] (p < 0.05) during period-2. Median annoyance ratings decreased from baseline 3.0 [IQR 2.0–6.0] to 2.0 [IQR 1.0–3.0] (p < 0.001) during period-2.

Conclusion

An architectural redesign resulted in a significant, clinically relevant decrease in sound levels along with a notable reduction in distractions. The multicomponent bundle lowered alarms and annoyance ratings; however, its effectiveness on other outcomes seems less persuasive.

Implications for Clinical Practice

Architectural redesign seems to be effective in controlling environmental noise.

Architectural redesign results in a decrease in nurses’ distractions during the medication preparation process.

The effect of an intervention bundle is, despite a positive effect on alarms and perceived annoyance, still insufficiently clear.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

降低中级护理病房的声级；准实验性时间序列设计研究

方法/设计在一家中级护理病房开展了一项采用时间序列和强化干预设计的准实验研究。先后引入了两项干预措施：在药物准备室安装隔墙（建筑重新设计）和实施捆绑式干预。主要结果测量加权声级（LAeq）、警报/天/床、烦扰评级（0-10 分数字评级表）以及护士在用药准备过程中分心的次数。结果LAeq基线与第一阶段相比，用药准备区从 56.8 (±5.0) dBA 降至 53.7 (±7.2) dBA（p < 0.001），护理站从 56.8 (±5.0) dBA 降至 54.3 (±4.0) dBA（p < 0.001）。在第 2 阶段，噪音进一步降低的幅度很小，甚至没有降低。警报次数中位数[IQR] 从基线期的 263 [IQR 193-320] 次增加到第 1 期的 394 [IQR 258-474] 次 (p <0.001)，然后在第 2 期降至 303 [IQR 264-370] 次 (p <0.05)。在第二阶段，烦扰度评分的中位数从基线 3.0 [IQR 2.0-6.0] 降至 2.0 [IQR 1.0-3.0] (p < 0.001)。对临床实践的启示建筑的重新设计似乎能有效控制环境噪声，建筑的重新设计减少了护士在药物准备过程中的分心，尽管干预捆绑对警报和感知到的烦扰有积极作用，但其效果仍不够明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.