Noise causes sleep disruption for ‘critical care’ patients

Prateek Tandon, Business Unit Manager-Ecophon, Saint-Gobain talks about the crucial role of good sound environment for rest and recovery, in hospitals and other healthcare facilities and highlights the relevant models in this direction

When we are sick we seem to forget that just opening the door to a hospital, takes us out of our comfort zone. Our system is already stressed and our senses are therefore alert. We are more sensitive to sound and noise than normal but in hospitals this can be a challenge.

A group of researchers at the Intensive Care Unit of Borås Hospital – Sweden, studied how critically ill patients are affected by sound. They found that the high sound pressure levels and noise peaks, make the patients stressed and less able to sleep. Sleep is one of the most important aspects of recovery.

The study also showed that there is a lack of knowledge regarding how sound and noise affect patients and staff. Further, the study confirms the importance of not only considering reverberation time, but also including acoustic parameters such as sound pressure level and speech clarity when choosing an appropriate acoustic solution.

Patients are certainly affected by sound levels in hospitals and over the years, the indoor sound levels have been increasing dramatically. The reason for this can be a combination of more people in the buildings, more equipment, more complex tasks and in general more sound sources.

High sound levels in healthcare facilities are known to: impair sleep, increase stress, delay post-illness rehabilitation, aggravate agitation, cause psychiatric symptoms, escalate restlessness, increase respiratory rates and increase heart rates.  There are studies which can also demonstrate a relation between being able to sleep well, recuperate faster and thereby shorter stays at a hospital. This proves to be commercially viable for the patient as well as hospital turn-around-times. Long-term research clearly shows that a proper room acoustic environment will:

– reduce sleep disruption

– reduce extra medication intake

– improve speech communication

 Understanding of sound and noise

In a similar study, questionnaires were distributed to 1,047 staff members at nine ICUs, to investigate and document the awareness of staff about the sound environment in an ICU. The researchers also performed 20 interviews with physicians, nurses and enrolled nurses. At the interviews, staff were also asked to give suggestions for improvements. The results of the questionnaires showed that none of the respondents knew all the answers, and in most areas the number of correct answers was low. Most people have never learned how sound affects us, and when it comes to physicians and nurses, their education and profession is about saving lives. Most respondents were convinced that management plays the most important role when it comes to securing a good sound environment.

Patients’ reactions and perceptions

To investigate how they experienced the sound environment of the ICU, the patients were interviewed 2–35 days after their discharge. All of the interviewed patients shared rooms with one or two other patients and the space was divided only by thin fabric curtain which made it possible for speech to be heard from one bed to another. Some of the patients also described the sounds as being scary and frightening and they felt like they had no way to shut off the unwanted and unpredictable sound.

So, it is evident that a good sound environment is crucial for rest and recovery, in hospitals and other healthcare facilities. In order to create a space where people can perform a certain activity comfortably and to the best of their ability, Saint-Gobain Ecophon from Sweden, developed a concept called Activity Based Acoustic Design. This is a method that anybody can use when acoustically designing indoor environments. In practice, it means defining the needs from three perspectives – activity, people and space and finding the common ground where all perspectives benefit. After this, optimal solutions are achieved using a combination of acoustic elements.

For instance:

Open plan Nurse Stations provide a specific working space for staff when they are not with patients. They are often the first point of call for visitors at a ward and the place where staff assemble for meetings and handovers. A calm space with easy communication is vital for staff comfort.

Recovering requires peace and quiet ambience. Rest and sleep are important aspects of our health and everyday life, but never as important as when we are ill or have undergone surgery and need to heal. For this reason, Treatment and Patient Rooms should be designed to promote good quality of sleep, comfort and privacy.

Waiting areas are regularly located in a corridor or an open space. Many waiting rooms have a counter where people can speak to the nurse or administrative staff. Patients and staff should easily be able to have private conversations without the risk of being overheard.

Laboratories are complex spaces where staff members work together analysing samples or data. Cleanliness, air pressure and air particles often need to be controlled to avoid risk of contamination whilst other areas may have a lesser requirement for cleaning.

A common characteristic of these environments is that most of them have specific hygiene demands. This could, for instance, be disinfection or water-resistance. Or maybe some surfaces need to withstand high-pressure washing. In order to create a healthy sound environment, it is important to use sound absorbing materials over ceilings or wall surfaces, that deliver the desired functions!