Vreman Jeanette , Lanting Cris , Frenzel Tim , van der Hoeven Johannes G. , Lemson Joris , van den Boogaard Mark
{"title":"降低中级护理病房的声级；准实验性时间序列设计研究","authors":"Vreman Jeanette , Lanting Cris , Frenzel Tim , van der Hoeven Johannes G. , Lemson Joris , van den Boogaard Mark","doi":"10.1016/j.iccn.2024.103810","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to assess the effectiveness of an architectural redesign and a multicomponent intervention bundle on noise reduction to enhance workplace safety.</p></div><div><h3>Methods/Design</h3><p>Quasi-experimental study with a time-series and intensified intervention design conducted in an intermediate care unit. Two interventions were sequential introduced: the installation of a partition wall in the medication preparation room (architectural redesign) and the implementation of an a bundle. Effects on outcomes were evaluated comparing baseline, after architectural redesign (period-1) and after implementation of the bundle (period-2).</p></div><div><h3>Setting</h3><p>Intermediate care unit.</p></div><div><h3>Main Outcome Measures</h3><p>A-weighted sound levels (LAeq), alarms/day/bed, annoyance ratings (numeric rating scale 0–10) and number of distractions of nurses during the medication preparation process.</p></div><div><h3>Results</h3><p>LAeq baseline vs period-1, decreased in the medication preparation area from 56.8 (±5.0) to 53.7 (±7.2) dBA (p < 0.001) and in the nursing station from 56.8 (±5.0) to 54.3 (±4.0) dBA (p < 0.001). During period-2, further noise reduction was minimal to absent. Distractions decreased from 58 % during baseline to 45 % (p < 0.001) during period-1, with no further reduction during period-2.</p><p>The median [IQR] number of alarms/day/bed increased from 263 [IQR 193–320] during baseline to 394 [IQR 258–474] during period-1 (p < 0.001), then decreased to 303 [IQR 264–370] (p < 0.05) during period-2. Median annoyance ratings decreased from baseline 3.0 [IQR 2.0–6.0] to 2.0 [IQR 1.0–3.0] (p < 0.001) during period-2.</p></div><div><h3>Conclusion</h3><p>An architectural redesign resulted in a significant, clinically relevant decrease in sound levels along with a notable reduction in distractions. The multicomponent bundle lowered alarms and annoyance ratings; however, its effectiveness on other outcomes seems less persuasive.</p></div><div><h3>Implications for Clinical Practice</h3><p>Architectural redesign seems to be effective in controlling environmental noise.</p><p>Architectural redesign results in a decrease in nurses’ distractions during the medication preparation process.</p><p>The effect of an intervention bundle is, despite a positive effect on alarms and perceived annoyance, still insufficiently clear.</p></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":"85 ","pages":"Article 103810"},"PeriodicalIF":4.9000,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0964339724001952/pdfft?md5=0e5e34d486e324822281099896dc75ff&pid=1-s2.0-S0964339724001952-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Reduction of sound levels in the intermediate care unit; a quasi-experimental time-series design study\",\"authors\":\"Vreman Jeanette , Lanting Cris , Frenzel Tim , van der Hoeven Johannes G. , Lemson Joris , van den Boogaard Mark\",\"doi\":\"10.1016/j.iccn.2024.103810\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>This study aimed to assess the effectiveness of an architectural redesign and a multicomponent intervention bundle on noise reduction to enhance workplace safety.</p></div><div><h3>Methods/Design</h3><p>Quasi-experimental study with a time-series and intensified intervention design conducted in an intermediate care unit. Two interventions were sequential introduced: the installation of a partition wall in the medication preparation room (architectural redesign) and the implementation of an a bundle. Effects on outcomes were evaluated comparing baseline, after architectural redesign (period-1) and after implementation of the bundle (period-2).</p></div><div><h3>Setting</h3><p>Intermediate care unit.</p></div><div><h3>Main Outcome Measures</h3><p>A-weighted sound levels (LAeq), alarms/day/bed, annoyance ratings (numeric rating scale 0–10) and number of distractions of nurses during the medication preparation process.</p></div><div><h3>Results</h3><p>LAeq baseline vs period-1, decreased in the medication preparation area from 56.8 (±5.0) to 53.7 (±7.2) dBA (p < 0.001) and in the nursing station from 56.8 (±5.0) to 54.3 (±4.0) dBA (p < 0.001). During period-2, further noise reduction was minimal to absent. Distractions decreased from 58 % during baseline to 45 % (p < 0.001) during period-1, with no further reduction during period-2.</p><p>The median [IQR] number of alarms/day/bed increased from 263 [IQR 193–320] during baseline to 394 [IQR 258–474] during period-1 (p < 0.001), then decreased to 303 [IQR 264–370] (p < 0.05) during period-2. Median annoyance ratings decreased from baseline 3.0 [IQR 2.0–6.0] to 2.0 [IQR 1.0–3.0] (p < 0.001) during period-2.</p></div><div><h3>Conclusion</h3><p>An architectural redesign resulted in a significant, clinically relevant decrease in sound levels along with a notable reduction in distractions. The multicomponent bundle lowered alarms and annoyance ratings; however, its effectiveness on other outcomes seems less persuasive.</p></div><div><h3>Implications for Clinical Practice</h3><p>Architectural redesign seems to be effective in controlling environmental noise.</p><p>Architectural redesign results in a decrease in nurses’ distractions during the medication preparation process.</p><p>The effect of an intervention bundle is, despite a positive effect on alarms and perceived annoyance, still insufficiently clear.</p></div>\",\"PeriodicalId\":51322,\"journal\":{\"name\":\"Intensive and Critical Care Nursing\",\"volume\":\"85 \",\"pages\":\"Article 103810\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-08-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S0964339724001952/pdfft?md5=0e5e34d486e324822281099896dc75ff&pid=1-s2.0-S0964339724001952-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Intensive and Critical Care Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0964339724001952\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0964339724001952","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Reduction of sound levels in the intermediate care unit; a quasi-experimental time-series design study
Objectives
This study aimed to assess the effectiveness of an architectural redesign and a multicomponent intervention bundle on noise reduction to enhance workplace safety.
Methods/Design
Quasi-experimental study with a time-series and intensified intervention design conducted in an intermediate care unit. Two interventions were sequential introduced: the installation of a partition wall in the medication preparation room (architectural redesign) and the implementation of an a bundle. Effects on outcomes were evaluated comparing baseline, after architectural redesign (period-1) and after implementation of the bundle (period-2).
Setting
Intermediate care unit.
Main Outcome Measures
A-weighted sound levels (LAeq), alarms/day/bed, annoyance ratings (numeric rating scale 0–10) and number of distractions of nurses during the medication preparation process.
Results
LAeq baseline vs period-1, decreased in the medication preparation area from 56.8 (±5.0) to 53.7 (±7.2) dBA (p < 0.001) and in the nursing station from 56.8 (±5.0) to 54.3 (±4.0) dBA (p < 0.001). During period-2, further noise reduction was minimal to absent. Distractions decreased from 58 % during baseline to 45 % (p < 0.001) during period-1, with no further reduction during period-2.
The median [IQR] number of alarms/day/bed increased from 263 [IQR 193–320] during baseline to 394 [IQR 258–474] during period-1 (p < 0.001), then decreased to 303 [IQR 264–370] (p < 0.05) during period-2. Median annoyance ratings decreased from baseline 3.0 [IQR 2.0–6.0] to 2.0 [IQR 1.0–3.0] (p < 0.001) during period-2.
Conclusion
An architectural redesign resulted in a significant, clinically relevant decrease in sound levels along with a notable reduction in distractions. The multicomponent bundle lowered alarms and annoyance ratings; however, its effectiveness on other outcomes seems less persuasive.
Implications for Clinical Practice
Architectural redesign seems to be effective in controlling environmental noise.
Architectural redesign results in a decrease in nurses’ distractions during the medication preparation process.
The effect of an intervention bundle is, despite a positive effect on alarms and perceived annoyance, still insufficiently clear.
期刊介绍：
The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.
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