0935 An Investigation of ICU Ambient Noise Levels as a Potential Source for Poor Sleep Outcomes in a Community Hospital Setting

Abstract

Abstract Introduction Patients in the intensive care unit (ICU) are subject to multiple necessary diagnostic and therapeutic interventions throughout the course of their treatment that contribute to sleep deprivation. These measures increase ambient noise, impacting patient morbidity and mortality by exacerbating confusion, ICU-related delirium, recovery time, and long term sequelae associated with Post-Intensive Care Syndrome. The World Health Organization suggests critically-ill patients not exceed exposure to sound levels higher than 35-40 decibels (dB). In this study, we measured ICU sound levels in a community hospital setting to support intervention with conservative bundle measures or behavior modification with a visual noise monitoring device. Methods This study took place over two months (October-November, 2021) in the critical care unit of St Agnes Medical Center in Fresno, CA. Ambient noise was monitored using a sound decibel meter (Gain Express Holdings, SLM-25) connected to recording software that measured the decibel levels at 1-minute intervals for 24 hours in three areas: two central stations (Station A and B) and one occupied patient room, equidistant to both central stations. The monitor data was exported to Microsoft Excel (2020 version; Microsoft Corp, Redmond, WA, USA) for analysis. Data from each sample was expressed as M±SE (95% confidence interval). Results Both central stations had average levels of 44.1dB± 4.7 and 48.0dB± 4.3, with a frequency range of 40-50 dB greater than 50% of the time. Station A had a frequency range of 50-60 dB approximately 11% of the time and Station B at 30% of the time. The occupied patient room had average levels of 48.0dB± 5.4, with frequency of 40-50 dB greater than 50%, and levels 50-60 dB greater than 30% of the time. Conclusion ICU’s with higher than recommended ambient sound levels may benefit from appropriate intervention such as visual noise monitoring devices or order-sets with protocols on equipment/staff phone volume, earplugs for patients, and limiting staff conversation to distances away from the bedside. Support (if any)