At night noises can seem louder. A drip from the faucet at home can drive you up the wall when you didn’t even notice it in the daylight hours. Now imagine what nighttime noises do when you’re in the hospital, on the mend after surgery or getting over a serious illness. Beeps and buzzes from monitors or nurses chatting outside your room can keep you from sleeping, leading to exhaustion and maybe even making your medical problems worse.
Recently Annals of Internal Medicine published a report that hospital noise keeps patients awake and can hinder their recovery. It may seem like common sense, but staff at Delaware hospitals said it helps to have the scientific proof to back up what many of them already believed – hospitals need to be more peaceful, particularly at night.
A.I. DuPont Hospital Senior Dir. of Acute Care Nursing Lori Polidore discusses efforts to reduce noise.
A.I. DuPont Hospital Senior Dir. of Acute Care Nursing Lori Polidore discusses efforts to reduce noise
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Many hospitals have heard complaints from patients about noise. Across the board, hospital officials said it was a top criticism in post-stay surveys, particularly the number and volume of public address system announcements.
At Bayhealth Medical Center in Dover and Milford, the “Quiet at Night” taskforce has monitored the hallways for noise levels, taking measurements during a couple of hours on each shift. The hospitals hope to get the noise level under 30 decibels by eliminating overhead pages, squeaking wheels, slamming doors and the like, said Donna Henderson, Planetree coordinator for Bayhealth. Planetree is an international organization that partners with healthcare providers for “patient-centered care.” Reducing noise levels is one of the group’s goals.
“During the day, most sounds are kind of muffled by all the activity that is going on,” Henderson said. “At night it seems much louder.”
Nanticoke Memorial Hospital in Seaford also named its initiative “Quiet at Night,” and many of the hospital’s efforts to foster a calm environment mirror those at Bayhealth. Nanticoke will also go a step further and give a signal on patient units that quiet time has arrived.
“At 10 p.m., after the last medication pass of the night, we’re going to play 10-15 seconds of music,” said Cathy Marketto, Nanticoke’s patient advocate. “Something soothing of course.”
She said the idea has been well-received by staff, who have offered musical suggestions. Along with the music, lights will be lowered, she said, “to set the tone, the mood.”
Marketto said it’s important to communicate with staff so they know what is expected in the nighttime hours. For nurses working directly with patients, or support staff who may be changing trash bags or mopping floors, the middle of the night is the “daytime” for on-duty employees.
Nanticoke leaders are also directing staff to communicate with patients about what noises are inherent to the hospital environment.
“There will be IV beeps that are extremely annoying and we know that, but it’s a safety feature,” Marketto said. “Maybe there’s another machine, monitors at the nurse’s desk that tell us about what a patient’s heart is doing. These are to keep them safe.
“We find that if we communicate with patients, those noises may not bother them as much.”
Beebe Medical Center in Lewes has been working on nighttime noise levels for about a year, said Jeannie Wallo, nursing supervisor at the hospital.
Highlights at Beebe include a “Yakker Tracker,” a monitor fashioned like a traffic light. As volume increases in a unit, the light changes from green to yellow to red to make people conscious of the noise level.
Staff members also have been given pins that say, “Talk Softly and Wear a Big Smile” to remind them that patients need their rest and a little TLC.
During a two-hour quiet time in the afternoon, Beebe caregivers dim lights on units to facilitate some rest during the day as well.
Beebe has also addressed small details, such as replacing all cart wheels with rubber ones and padding the landing areas of the pneumatic tube system used to move items around the building. And staff will continue to look for ways to improve.
“We’re always open to suggestions,” Wallo said. “But I think the most important thing here is awareness.”
Alfred I. duPont Hospital for Children is currently going through an extensive renovation and expansion. Many of the planned changes reflect suggestions made by patient and family advisory boards, with the goal of bringing a more peaceful setting to patient recuperation, said Lori Polidore, senior director of acute care nursing.
For example, all patient rooms will be private rooms when the expansion is finished. This will give families privacy and eliminate roommate noise. To eliminate overhead paging, the hospital is moving to a wireless communication system, as most other hospitals are doing.
Nurse clinician Mike McCorkle demonstrates A.I. duPont Hospital for Children's new quiet paging and alert system.
Nurse clinician Mike McCorkle demonstrates A.I. duPont Hospital for Children's new quiet paging and alert system.
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Through a badge pinned to his shirt, Mike McCorkel can receive alarms from monitors for apnea, heart problems, and a host of other conditions. The monitors are linked up to his communicator at the beginning of his shift.
The wireless badge communicators are not only a lot quieter for patients, McCorkel said, they also make nurses’ work more efficient. From his badge, McCorkel can call for assistance from other nurses on the unit and even page a doctor.
While the current system is an improvement for patients and staff,, Polidore said the hospital will soon look at the next generation of wireless communication to stay up to date with technology.
New additions to 24-bed units in the hospital will also include “pocket parks,” where patients and families can enjoy calm areas with natural light, and “serenity rooms,” where families can take a minute or have a meeting.
“It’s not just the medical things we do,” Polidore said. “We need to incorporate everything, from light to noise in space for patients.”