Effectiveness of a noise reduction intervention in the intensive care unit: A prospective bicenter study

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.

Keywords: Noise reduction; Intensive care units; Educational interventions; Behavioural interventions; Healthcare effectiveness; Patient outcomes; Prospective interventional study; Sound levels

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.