Implementation of noise-reduction strategies and designated quiet time in an intensive care unit

Abstract

Excessive noise is a considerable problem in intensive care units, interfering with patient rest, recovery times and patient satisfaction. This quality improvement project aimed to implement and evaluate noise-reduction strategies in a coronary intensive care unit in Doha, Qatar. Rapid plan-do-study-act cycles were used to implement several noise reduction strategies, including the introduction of two designated quiet time periods per day (15:00–16:00 and 2:00–4:00), staff education about the impact of noise, environmental adjustments and an audio-visual device to alert staff, patients and visitors of excessive noise levels. A sound metre app was used to measure noise levels for 4 months before the intervention and for nearly 3 years (April 2018–December 2020) after implementation. Surveys were used to collect informal feedback from staff and patients on the ward. The average pre-intervention noise level on the unit were 64.6 dB, which was reduced to a consistent average of 24 dB during designated quiet times following the interventions. No adverse effects on communication or medical errors were observed. Patient and staff feedback was positive, with most patients (n=50) and all staff (n=86) being satisifed with the noise levels following the intervention. Although the nature of activity in intensive care units makes them noisy environments, it is possible to reduce noise levels by targeting modifiable factors and implementing simple measures, such as dedicated quiet times, staff education and audio-visual noise alerts.