| It is widely recognized that physical environments directly affect human physiological and mental well-being. Noise, a recognized environmental stressor, contributes to poor patient satisfaction and is known to disrupt patient sleep. This study investigated the relationship of sources of noise to sleep disruption in three units of a large urban hospital. A volunteer sample of 61 discharged patients completed a survey asking about the sleep disruptive nature of 33 (25 noise related and 8 non-noise related) environmental factors. The results revealed that a total of 17 factors were found to be sleep-disruptive by at least one-third of the patients (11 noise-related and 6 not associated with noise). Beeping of the IV pump, intercom paging within the room and activities associated with a nurse entering the room were ranked the highest among noise-related factors. Comfort of the bed and nursing/medical interventions were the two factors with most responses in the non-noise category.; Based on these findings a set of design recommendations was developed that hospitals might adopt to eliminate the source of a noise, reduce its occurrence, or lessen its volume. Two key design recommendations consist of incorporating all private patient rooms and decentralizing nurses' stations. These conditions hold the potential for reducing the noise generated by staff conversations and excessive traffic by providing all essential elements of care within near proximity of the patient room and eliminating noise generated within the room by the presence and care associated with another patient. Additional recommendations include relatively specific design changes such as replacing sound indicators with light-indicators on medical equipment, reducing staff bedside checks by providing visual access into patient's room from the corridor and using floor finishes with sound absorbing qualities and walls with sound attenuation materials. Design recommendations were developed for each harmful stressor identified by at least one-third of the respondents and were organized by the location of the source (bedside, room, and corridor). Recommendations include a list of possible solutions to prevent or reduce the noise at its source, and also to provide a space capable of preventing the transmission of sound once it is generated. Additional recommendations were made as related to the behavioral/operational factors and non-noise factors such as the patient bed, pillows, temperature and lighting. Overall the study found that noise is a factor which negatively affects patient sleep. The presence of noise can be reduced with a well-informed design approach. |
