Hospital Noise and the Patient Experience . This might be a good article to post in your break rooms, or to bring to a UBC meeting!
I hope everyone is enjoying Journal Club and that you are finding the articles useful to your nursing practice. The comments left on this blog are awesome, but then, everyone knows that the nurses at MRMC are the brightest bulbs in the box! After posting, I encourage you to continue reading others thoughts and enjoy the oncology related links on the right hand side of the blog.
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Questions
- What does Press - Ganey have to say about hospital noise?
- What do you think about the Multidisciplinary Sound Quality Committee mentioned in the article?
- How does noise and auditory clutter put nurses at risk?
Discussion question for the blog: What can you personally do to promote a more peaceful and quiet environment for our patients and other nurses?
Courtney Blinten
ReplyDeleteDiscussion question for the blog: What can you personally do to promote a more peaceful and quiet environment for our patients and other nurses?
Talk in a regular voice, don't shout down the hallway. Assertively ask other staff members to not shout. Turn cell phones and portable phones to vibrate, especially when in ICU.
Nancy Cullen
ReplyDeleteI agree with Courtney that by talking in a regular voice and not shouting long distances can help promote a peaceful and quiet environment; but also feel that by staying calm and relaxed can also help create a better environment for nursing staff as well as patients. Also, decreasing multiple conversations at the desk,or multiple consults at one time where many people are talking at the same time, sometimes louder than others,can be of benefits. Alternatives areas that can be used for conversations can be conference rooms, md offices or workrooms. Appropriate use of cell phone, and cellphones on vibrate also can decrease noise levels.
I always try to keep my cell phone on a low ring level and always step out into the hallways to take a call. Talk in a lower voice in the hallways and do not yell down the hallways. Keep conversations at the nurses station to a lower level and if things need to be discussed in detail step into the med room or an unoccupied room to keep the noise down.
ReplyDeleteI advocate doing staff education teaching the nursing and ancillary staff about the effects of noise and the importance of noise reduction for patient healing. Keeping the tone of voice low during casual conversations, interaction with other providers during consultations, and putting phones on vibrate mode would help in dcreasing the intensity of noise level in the work area. Nancy mentioned a good point of using alterante places to discuss cases during the consult especially if there are multiple consults and conversation going on at the same time. We could also help patients if they want to relax and not be bothered by any distractions or noise by providing them with ear plugs or sleeping masks depending on their conditions and care needs. Avoid distant conversation with each other, use personal phone in appropriate places where there would be privacy.
ReplyDeletePersonally I can have a heightened awareness of the volume of my voice and actions. I have a personal responsiblity as well to provide reminders for others when the noise level is elevated. In my opinion, when we are busy the noise becomes the "norm" in our environment. This article has provided an important insight from the patient perspective as well as the ramifications of noise and risk it puts nurses in.
ReplyDeleteYes! Educate and lead by example! This is one of my most favorite articles. A BIG thank you to the person who found this article! Noise pollution is detrimental to the health of patients and staff. The energy it takes to block out the noise is very draining. Dr. Masaru Emoto, a Japanese scientist, who wrote "Hidden Messages in Water" and "The Healing Power of Water", did experiments with water. He discovered that the water that was exposed to loud,"angry music", caused the water crystals to be become distorted and assymetrical. The water that was exposed to soothing, calming, or classical music, caused the water crystals to look like beautiful, symetrical snowflakes. Our own bodies are made up of 70% water. Can you imagine the effect it has on us at the cellular level!
ReplyDeleteAs nurses we can encourage by example. Use your "indoor voice", especially if your voice is naturally loud. Make a conscious effort to speak more softly, be aware of patient's trying to rest and relax. When our Infusion Center is at capacity, you can imagine when everyone's TV is on, caregivers or patients are talking on cell phones, pumps beeping-(we have 80 some pumps in our area), phones ringing, pyxis doors opening and closing, call lights on, ancillary staff in the area, conversations between nurse and nurse, or nurse and patient and sometimes all at the same time! I remember when there used to be signs posted outside hospitals that said "QUIET ZONE". We need more of that. I also challenge the manufacturer of pumps to come up with better designs in regards to providing different alert sounds on their pumps. Not every alert is an emergency! None of us can be 2 places at once and pumps far out- number nurses.
I have to admit that staff can sometimes forget the setting they are in when having conversations rather it is casual or patient related. The tone can get carried away and become way too loud. Being alert and educated to speaking in low tone voices as not to distract or disturb patients is essential to patient satisfaction and sound quality of the environment. Having representatives in each area to help in keeping noise levels down would help in these noise situations.
ReplyDeleteBe conscious of where you are and how loud you are. Ask fellow coworkers who are getting loud during conversation to quiet down. Respect patients and roommates of the noise level of the other patients as well. Move them to another room if loud family members are an issue.
ReplyDeleteThe quickest way to reduce noise is to speak in a controlled, lower tone of voice. Follow simple rules of converstion etiquette and go to an area with less noise if communication is needed so as not to contribute to the noise clutter
ReplyDeleteEnsure when speaking to a patient you are speaking at a reasonable volume. Eliminate elective noises such as television, radio's or cell phones when needed. Ensure beeping pumps are attended to promptly. Something interesting...I've actually worked at a facility that asked staff not to wear high heels in the hallways where the floors are not carpeted to promote rest and healing.
ReplyDeleteMaintaining the optimal noise level in the hospital is difficult. Noise levels are often controlled by our emotions. When we are happy or excited we tend to be louder; As is the case with frustration, anger and stress. We all know that we encounter all of these emotions often in our daily work life. So, we need to make ourselves cognizant of how loudly we are speaking. We need to remember the wise words of our parents and teachers...use your inside voice! If we all try to remember this and give our co workers friendly reminders, maybe we can make a difference in the noise level in our hospital.
ReplyDeleteAll excellent recommendations. First I would assess the environment for sources of noise. Where do people congregate to chat, especially on cell phones, what equipment noise is offensive, and what contributes to the underlying, constant hum of noise? Then create solutions from this assessment, i.e. locations for cell phone use (and not for use), not calling down hallways,turn cell phone ringtone volumes down. I like the idea of relaxation music accessability for every patient bed. Unsure what to do with the pump alarms.
ReplyDeleteTo promote a peaceful enviroment I always like to offer the patients headphones for their tv. Also it is always important to keep our voices down around patient rooms. In the infusion center we have massage and heat chairs, and recently we had the big tv out front by the windows removed to make it more peaceful.
ReplyDeleteI think it is unnecessary to wake patients to take vital signs or to give medication when it can wait. I try to advocate that with my PCT's. I also think visitor noise is becoming a problem. Large families and those with small children should be asked to either keep the noise down or if possible visit with the patient in the waiting room. Another problem with noise is patients who are constantly vomiting or in pain. If possible these patients should be kept to a room by themselves. These patients should also be attended to as soon as possible to keep their symptoms under control.
ReplyDeleteTo make the work environment a more peaceful and quieter place for our patients and co workers, we need to remember to have respect for everyone and speak in a manner that is not disruptive or loud in our work areas.
ReplyDeleteSome things we may suggest or offer patients/ co workers to lessen the noise level would be to offer headphones to patients while watching tv, or having them turn on the relaxation channel(healing videos) to make the environment a little more peaceful(but keep the volume to a medium). In the infusion center, we eliminated the big tv in the front area by the bay window as that was a complaint/distraction to many patients(when they just wanted to peacefully lie there and receive chemotherapy), we have massage/heated chairs and warm blankets to put patients at ease. Basically though, have respect for those around you. As stated, setting sound standards makes it possible for a patient to move through the healthcare system, from department to department, and experience the same standards of care throughout their length of stay.
Quiet is very calming when we are stressed or fearful. Have you ever walked by a nurses' station where they are really loud? We all need to keep our voices lower, remind others to do the same. Turn ringers off on cell phones, keep TV's at a reasonable volume, play soothing music, remember we work in a hospital.
ReplyDeleteDoris Tenneson
ReplyDeletecreating a quite environment for patient’s and nurses can be a challenge especially when there are Nurses, Doctors, secretaries, practitioners’ and non professionals congregating in an area that is small and enclosed. This has become more of a problem since the increase in staff and not enough workspace. Sometimes staff will become offended when you ask them to step away from the nursing station because they’re talking loudly on a cell phone while you’re juggling to answer the telephone, and answer questions from patients, or staff. I believe we should not be afraid to let our coworkers know when the noise level has become a problem to those around them. How can we promote a peaceful environment if no one is willing to acknowledge a problem especially with the increase in cell phone use in the hospital setting?
All recommendations are excellent and I agree with all of them. In addition, we need to remember we are in a hospital environment and should remain professional at all times. Increased noise and distractions can affect not only the patient's experience but all the staff in the area. Effective communication is vital to all phases of a nurses role.
ReplyDeleteHeadphones for patients, closed doors, turn down ringer volume on phones, keep personal conversations low and away from patients....and fix the noisy trash carts that rumble down the uncarpeted hallway several times daily.
ReplyDeleteHi everyone!
ReplyDeleteFirst, I think it's great that CTCA has no overhead paging system--it really cuts down on noise. I am aware of the difference when I go to other hospitals, for appointments!
I agree with the responses that people have posted thus far. On a side note, I work in the Infusion Center. We carry phones with us. They ring frequently, and the ringer (even on the softest setting), is loud. We are often in patient bays, and I find them disruptive to patient care--sometimes they jostle a patient awake! I wish they had the capability of text, or to leave a voicemail! This would help A LOT.
Theresa Rodriguez, BSN
Infusion
Personally I think that noise disrupts patients who already have little time to rest. It can also be distracting to other nurses who are trying to concentrate on tasks. Sometimes as nurses we do not realize how loud we are being and that is a fault of ours that we must sometimes be reminded of.
ReplyDeleteWhat can you personally do to promote a more peaceful and quiet environment for our patients and other nurses. First, be aware of where you are. Look around your surroundings you are not at a friends house, bar or resturant....you are at a hospital. We need to be reminded of our surrondings. We need to have posted signs like mentioned above of quiet environment, this is a simple but nice reminder of what is an appropriate volume of speach. For our nurses, again any type of increase noise is a distraction to them. We as nurses face to many distractions, cell phones, people talking, monitor noises, ect. This leads the nurse to not be 100% focused on tasks at hand putting our selves and our patients at risk. Please be be quiet around nurses who are charting, passing meds and assessing patients. Please allow us to focus on the task at hand. By, Tami Z.
ReplyDeleteAs nurses, it's our duty to not just be cognizant of the volume of our own voices, but also of the noise we create as we perform our nursing duties. It is our duty to provide an environment as sound-free as possible by avoiding unnecessary conversations @ the bedside, in the nurses station, and in hallways; and promoting others to do the same.
ReplyDeletejennifer castro
ReplyDeleteTo promote peaceful and quiet environment for our patients, it is our duty to cut down the noise to a minimum. i'm glad we don't overhead page doctors like other hosp.do. we also should not be using cell phones in the hosp. but if i know that everyone carries them so maybe just put them on vibrate. If we hear other nurses talking loudly in the nurses station, we could tell them in a nice way that patients need their rest so please put the volume of their voices on low.
I feel that our hospital does an excellant job of when it comes to inpatients. The clinic can be very noisy at times though as their is always alot going on. The reduction of noise for inpatients is esential for the patient to rest and feel better expescially when in pain or after bad news. This is one way to respect the patients.
ReplyDeleteAs a nurse in the infusion center it is a large open space with only curtains and half walls dividing the patients so one effort could be to offer headphones to patients so that the noise from the TV is not overwhelming. Another step that I can take is to take the time and walk to another nurse and talk to her about something instead of blurting it out from across the nurses’ station.
ReplyDeleteThe infusion center can be a noisy place. To reduce unwanted noise, turning down the pump alarms so they won't startle or irritate patients is a good start. TV volumes could also be kept at moderate to low levels, and offering head-phones for the hard of hearing would be ideal. Keeping personal conversations to a minimum would promote a more patient-centered atmosphere while providing better focus for the staff. Placing kind reminders to staff and guests that noise levels should be kept at a low-to-moderate level will keep everyone mindful of the environment of healing.
ReplyDeleteHospitals can be a noisy place for both patients and employees. reducing unwanted noises and distraction can benefit patient's and staff. patient's can rest and recover and staff can concentrate and perform their duties without the added distraction. One way to reduce noise in the work area is by being aware of how loud your voice is when talking to coworkers or patient/family members and to always remember to keep personal conversations away from nurses stations or patient rooms.
ReplyDeleteTerry Watt
ReplyDeleteA peacefull and quiet environment is an aid to better healing for our patients. Personally I can promote a quieter environment by speaking in lower tones, checking that the environment is not contribuitng to excess noise and promoting a "Quiet Please, healing in progress" type of atmosphere.
Ihave to admit, i am one of the people who, called down the hallway, when asking a coworker somthing, this article made me aware of what i am doing, so for now on, i will speak in a low tone and reduce the ring tone on sds phones
ReplyDeletePersonally I can help create a peacefull quiet hospital enviroment by speaking in a lower tone of voice, closing the doors in the patient room to contain the noise outside. Lower the volume of the ring tone in the patient's room. Advocate a quiet, peaceful, stress free hospital care environment aid in patient's early recovery & healing.
ReplyDeleteWhat can you personally doto promote a more peacful and quiet environment for our patients and other nurses ?
ReplyDeleteTo promote a more peaceful and quiet environment , we have to minimize the noise in the hall ways , in the room . Turn down the noise of the TV and offering a head phone most especially if they are sharing another room with patients.