30 March 2016
- Team work with staff and patients to make the intensive care unit a quieter place to recover
- Noise levels can sometimes rival a pneumatic drill
- Simple changes could make a difference
TV presents one picture of an intensive care unit (ICU) – dimmed lights, hushed voices and softly bleeping machines. The reality is that it’s more like a busy restaurant and frequently it’s noisy enough to compete with a pneumatic drill.
That’s why Oxford University researchers have been trying to make intensive care noise less intensive.
Professor Duncan Young from Oxford’s Kadoorie Centre for Critical Care Research and Education said: ‘High levels of noise make it harder to sleep, sleep deprivation leads to confusion, and confusion is thought to complicate the healing process and slow recovery.
‘Yet our research found that during the day, noise levels in an ICU are equivalent to those of a busy restaurant. While things are quieter at night, we still found that sounds louder than 85 decibels – around the level of a road drill – were happening up to 16 times an hour.’ This research is available online from the Critical Care journal website.
Concern that intensive care noise was delaying recovery led to a £280,000 grant from the National Institute for Health Research (NIHR), to understand the noise issues and then work to reduce them.
Professor Young explained: ‘Patients may get earplugs and eye masks to help them sleep, but that doesn’t deal with the underlying issue. We talked to patients, visitors and staff to find out if particular noises cause more disturbance. We also spent time in an intensive care unit watching and listening to identify the main sources of noise and how patients and staff reacted to them.’
The information was used by a group of staff and patients from the Oxford University Hospitals NHS Foundation Trust to help design a programme of noise-reducing changes. These included replacing noisy metal bins with quieter plastic ones, and introducing new guidelines to ensure the volume settings on equipment are appropriate and that staff try to keep a more normal day and night routine.
Online training for local hospital staff helps show how easily noise levels can rise, and how different noises affect patients. Based on patients’ suggestions, staff can also experience the ICU from the patient perspective. Wearing glasses that simulate the poor vision common in many patients treated in the ICU, they hear a soundtrack of common sounds in the unit while people move around the bed, as staff would do during routine nursing activities.
Professor Young said: ‘The experience helps staff understand things from the patient’s point of view, and most of those who have been through the training have said that they will change the way they work.
‘The next stage is to develop a noise display, so staff can see and better manage the noise level in the unit. Taken together, we hope all these activities will make intensive care a better environment for patients.’
For more information or to request an interview please contact Tom Calver on 01865 270046 or firstname.lastname@example.org
Notes to Editors:
The project will make a final report in mid-2017. Meanwhile, members of the public wanting more information about the project can contact email@example.com or follow the Critical Care Research Team on Twitter @KadoorieCentre
The original research on ICU noise levels is available at: http://ccforum.biomedcentral.com/articles/10.1186/cc12870
Details of other projects run by the Kadoorie Centre Critical Care Research Group can be found on their websites: http://www.ndcn.ox.ac.uk/research/critical-care-research-group-kadoorie-centre and http://www.ouh.nhs.uk/kadoorie/research/critical-care-research.aspx
The research grant has been made available by the National Institute for Health Research (NIHR) Research for Patient Benefit Programme. This is a national programme which aims to generate high quality research for the benefit of users of the NHS in England. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. The NIHR is the research arm of the NHS. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).
The project is also supported by the University of Oxford, the Oxford University Hospitals NHS Foundation Trust, the NIHR Oxford Biomedical Research Centre, and the NIHR Clinical Research Network.