Critical care nurses should help in reducing noise to improve the well-being of patients and health care providers. To measure actual noise levels in intensive care units, identify nurses' perceived irritation levels of noise sources and examine the impact of noise on nurses' work performance and well-being. This cross-sectional study was conducted from January to April 2023 at a teaching hospital's six intensive care units. It involved three phases: mapping locations for noise measurement, actual noise measurements in decibels and a cross-sectional survey to identify nurses' perceptions and the adverse effects of noise. Actual noise was measured between patients' beds, nursing stations and beside 16 noise sources for 7 days 24 h a day. For nurse perceptions, the mean of perceived irritation levels by a Likert scale for each noise source was calculated to present perceived noise levels. Ranking of noise sources according to the actual measured and perceived irritation by nurses was done based on mean values. Curve estimation regression test was used to predict the relationship between actual and perceived noise and stepwise multiple linear regression identified factors associated with noise adverse effects. The mean noise level in the intensive care units was 65.55 dB. Nurses perceived mechanical ventilator alarms as the most irritating noise. However, the mean noise measurements showed that conversations among colleagues were the primary source of noise. There was no significant predictive relationship between the actual and perceived noise. Nurses reported feeling distressed, irritable, fatigued and less productive due to noise. There was a discrepancy between actual and perceived noise levels by nurses. Perceived noise levels had more impact on nurses than actual noise. By incorporating both objective measurements and subjective perceptions into efforts aimed at reducing noise, health care providers can create quieter intensive care units.
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