| Objective To apply the PDCA circulation in the management of ward noise tentatively, increase nursing staffs understanding to the hazard of noise, improve their consciousness to control the noise, and change it from passive control to active control to provide the basis for implementing noise free ward.Methods Using convenient sampling method, the noise management questionnaires were sent to patients in the department of respiration to obtain current situation of noise management from January to March2013, and census the key sources, key periods and key locations of the noise. From2013-04-01to2013-04-03the specially trained personnel used GM1358digital noise meter to conduct a continuous detection for general information of the ward noise in different periods, different locations and different sources. To apply the PDCA circulation in the management of ward noise, and establish an assessment group taking brainstorming to analyze the causes of noise with fishbone diagram, distinguish between intervention and unforeseeable factors, take the intervention factors as an entry point, apply the PDCA circulation to the key sources, key periods and key locations of the noise respectively, all levels of PDCA circulation form the pattern of small rings in large rings, solve the problem layer by layer and promote each other, so that the whole problem of PDCA circulation goes around. In the circulation process, summaries are needed to deal with the hangover and analyze their causes, then it goes to the next PDCA circulation. Our study conduct the ward noise investigation with the noise management questionnaires and GM1358digital noise meter,3months later degree of noise interference, satisfaction to noise control, intensity of ward noise and the improvement of sleep time were compared between patients before and after intervention.Data were analyzed with SPSS17statistical software, numerical variable data were compared with t test and categorical data by x2test. P<0.05had significant differences.Results200patients were involved in the investigation before and after PDCA circulation, there is no significant differences in gender, age and the prevalence of illness between the two groups, the main results are as follows:1.200patients were involved in the investigation, among which before the intervention group27.5%(55) patients were severely affected by the noise, while60%(120) were less severely affected;57.5%(115) were unsatisfied with the ward noise control, and merely26%(52) were satisfied with it. After the intervention patients who were less severely affected reduced to92, a decrease of23.3%, and those who were severely affected reduced to38, a decrease of30.9%; patients that were unsatisfied with the ward noise control reduced to72, a decrease of37.3%, and the satisfied patients increased to108, an increase of51.8%. After the intervention, patient’s subjective sensation to noise interference decreased, and to ward noise control increased, which means there’s statistical significance (P<0.05)2. The results showed that noise in the ward, nursing station, corridor and surrounding environment all decreased from10:00to12:00through the PDCA circulation, the difference was statistically significant (P<0.05); from17:00to19:00the difference of noise in the ward, nursing station and surrounding environment was statistically significant (P<0.05), while that of the corridor wasn’t statistically significant (P>0.05); from20:00to22:00the difference of noise in the ward, nursing station and surrounding environment was statistically significant (P<0.05), and there’s no obvious difference in the corridor which means no statistically significant (P>0.05); from22:00to6:00noise of those4places all decreased, the difference was statistically significant (P<0.05). The sound of wheels, door close, call bell and the intensity of staff’s speaking voice all decreased, the difference was statistically significant (P<0.05)3. Through the PDCA circulation, the number of patients whose sleeping time is6h increased from42to75, an increase of44%, those whose sleeping time is5h increased from31to56, an increase of44.6%, and there is an58.7%decrease for patients whose sleeping time is4h, the number decreased from97to40. The difference was statistically significant (P<0.05)Conclusion The PDCA circulation can reduce the noise pollution, improve ward environment, prolong the sleeping time, and achieve harmonious relationship between nurses and patients, at last help to improve patients’ satisfaction to the nurses’job,it could also be applied in other areas of nursing. |
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