Ong B, See KC, Kim SS, Lau YH. Effectiveness of a noise reduction intervention in the intensive care unit: A prospective bicenter study. World J Crit Care Med 2025; 14(4): 106359 [DOI: 10.5492/wjccm.v14.i4.106359]
Corresponding Author of This Article
Bernard Ong, Department of Anaesthesiology, Singapore General Hospital, 31 Third Hospital Ave, Singapore. dr.ongbernard@gmail.com
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Critical Care Medicine
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Prospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 9, 2025 (publication date) through Dec 9, 2025
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World Journal of Critical Care Medicine
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2220-3141
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Ong B, See KC, Kim SS, Lau YH. Effectiveness of a noise reduction intervention in the intensive care unit: A prospective bicenter study. World J Crit Care Med 2025; 14(4): 106359 [DOI: 10.5492/wjccm.v14.i4.106359]
World J Crit Care Med. Dec 9, 2025; 14(4): 106359 Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.106359
Effectiveness of a noise reduction intervention in the intensive care unit: A prospective bicenter study
Bernard Ong, Kay Choong See, Sunny Sunwoo Kim, Yie Hui Lau
Bernard Ong, Department of Anaesthesiology, Singapore General Hospital, Singapore 168753, Singapore
Kay Choong See, Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, Singapore 119074, Singapore
Kay Choong See, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
Sunny Sunwoo Kim, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Yie Hui Lau, Department of Anaesthesiology, Intensive Care and Pain Medicine, Tan Tock Seng Hospital, Singapore 308433, Singapore
Author contributions: Ong B contributed to writing, data collection; See KC, Lau YH contributed to conceptualization, methodology, writing, supervision, project administration, investigation; Kim SS contributed to data collection.
Institutional review board statement: Ethics approval for this study was waived by the National Healthcare Group Domain Specific Review Board (DSRB reference number 2023/00558).
Informed consent statement: Informed consent statement was waived by the National Healthcare Group Domain Specific Review Board (DSRB reference number 2023/00558).
Conflict-of-interest statement: The authors declare no conflicts of interest pertaining to this research.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: No patient identifiable data was collected during this study. There was no requirement for informed consent.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bernard Ong, Department of Anaesthesiology, Singapore General Hospital, 31 Third Hospital Ave, Singapore. dr.ongbernard@gmail.com
Received: February 24, 2025 Revised: April 1, 2025 Accepted: May 29, 2025 Published online: December 9, 2025 Processing time: 277 Days and 6.1 Hours
Abstract
BACKGROUND
Excessive noise in healthcare environments—commonly described as "unwanted sound"—has been linked to a range of negative impacts on both patients and staff. In clinical settings, elevated noise levels have been associated with sleep disruption, heightened cardiovascular stress, and an increased risk of delirium in patients. Among healthcare workers, noise can impair focus and cognitive performance, potentially compromising care quality.
AIM
To evaluate the effectiveness of educational and behavioural interventions in reducing noise levels within intensive care units (ICUs), recognizing their potential impact on patient outcomes and healthcare effectiveness.
METHODS
A prospective interventional study in two Singaporean teaching hospitals compared peak and average sound levels between control and intervention groups. An educational and behavioural intervention comprising talks, posters, and self-audits by nurse champions was initiated in two ICUs in one hospital on November 18, 2023. Sound measurements were collected at 4 Locations within each ICU before and after intervention. Baseline measurements were taken from October 22, 2023 to October 29, 2023, and post-intervention measurements from December 21, 2023 to December 22, 2023. The hospitals served as the primary exposure variable, controlled for ICU type (medical vs surgical) and hour of the day.
RESULTS
Our analysis generated 48 pairs of peak and average sound level readings for each unit (control n = 48 readings; intervention n = 48 readings). The effect of the intervention was associated with a significant 4.8 dB decrease in average sound level (P = 0.009) and a nonsignificant 4.3 dB decrease in peak sound level (P = 0.104), adjusted for hour of day and type of ICU.
CONCLUSION
Educational and behavioural interventions successfully reduced average sound levels, emphasizing their positive impact on noise control. These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings. Future studies may explore additional systemic and environmental interventions to enhance noise management strategies.
Core Tip: Educational and behavioural interventions demonstrated success in reducing average sound levels, emphasizing their positive impact on noise control. These findings contribute valuable insights for optimizing noise reduction efforts in critical care settings.
