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April 2012, Volume 42 Number 4 , p 14 - 15


  • Bonnie Haupt MSN, RN, CNL-BC


"UNNECESSARY NOISE is the most cruel abuse of care which can be inflicted on either the sick or the well," according to Florence Nightingale.1 As part of our organization's journey to patient-centered care, the VA Connecticut Healthcare System in West Haven is evaluating innovative ways to provide an optimum healing environment. Our facility had already implemented the "Silence for Healing and Holistic Health (SHHH) Program" hospital-wide to increase awareness of the adverse effects of noise on the physical and mental health of patients, families, and staff.2 (See Quiet initiatives.)Our 30-bed medical-surgical unit has taken the SHHH Program one step further by starting a Quiet Hour. This article describes the project our unit undertook to institute a Quiet Hour and our survey results before and after its implementation.The number of patient rooms and the amount of equipment, as well as environmental design, intercom systems, and patient acuity, are factors that influence noise levels in healthcare facilities. Studies have shown these noise levels have negative psychologic as well as physical effects on patients during hospitalization.For example, one study showed that noise levels can increase BP, decrease oxygen saturation, disrupt sleep, and delay wound healing.3 Another study also supports the finding that overall noise levels can increase BP. 4The first step in reducing noise in hospitals is identifying its sources. A digital decibel meter measures the sound levels of specific areas of the hospital at different times of day. As the clinical nurse leader, I initially assessed noise levels on our busy unit, noting increased noise levels at certain times of the day. The unit was particularly noisy between 1300 and 1500 hours due to patients returning from procedures, healthcare provider rounds, and lunchtime cleanup.We then distributed a short questionnaire to patients and families. Participation was voluntary and anonymous for inpatients on our unit who were competent,

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