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Striving for Optimum Noise-Decreasing Strategies in Critical Care: Initial Measurements and Observations

Disher, Timothy C. BScN, RN; Benoit, Britney RN; Inglis, Darlene RN; Burgess, Stacy A. MHA; Ellsmere, Barbara RN; Hewitt, Brenda E. MN, RN; Bishop, Tanya M. BScN, RN; Sheppard, Christopher L. MSc; Jangaard, Krista A. MD, FRCPC; Morrison, Gavin C. MD; Campbell-Yeo, Marsha L. PhD, NNP-BC

The Journal of Perinatal & Neonatal Nursing: January/March 2017 - Volume 31 - Issue 1 - p 58–66
doi: 10.1097/JPN.0000000000000229
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To identify baseline sound levels, patterns of sound levels, and potential barriers and facilitators to sound level reduction. The study setting was neonatal and pediatric intensive care units in a tertiary care hospital. Participants were staff in both units and parents of currently hospitalized children or infants. One 24-hour sound measurements and one 4-hour sound measurement linked to observed sound events were conducted in each area of the center's neonatal intensive care unit. Two of each measurement type were conducted in the pediatric intensive care unit. Focus groups were conducted with parents and staff. Transcripts were analyzed with descriptive content analysis and themes were compared against results from quantitative measurements. Sound levels exceeded recommended standards at nearly every time point. The most common code was related to talking. Themes from focus groups included the critical care context and sound levels, effects of sound levels, and reducing sound levels—the way forward. Results are consistent with work conducted in other critical care environments. Staff and families realize that high sound levels can be a problem, but feel that the culture and context are not supportive of a quiet care space. High levels of ambient sound suggest that the largest changes in sound levels are likely to come from design and equipment purchase decisions. L 10 and L max appear to be the best outcomes for measurement of behavioral interventions.

IWK Health Centre, Halifax, Nova Scotia, Canada (Messrs Disher and Sheppard, Drs Benoit, Jangaard, Morrison, and Campbell-Yeo, and Mss Inglis, Burgess, Ellsmere, Hewitt, and Bishop); and Dalhousie University, Halifax, Nova Scotia, Canada (Mr Disher and Ms Benoit, Drs Jangaard, Morrison, and Campbell-Yeo).

Corresponding Author: Marsha L. Campbell-Yeo, PhD, NNP-BC, Dalhousie University School of Nursing, Forrest Bldg, 6299 South St, Halifax, NS B3H 1×7, Canada (

This work was supported by an IWK Foundation Translating Research Into Care (TRIC) grant. Disher is supported by a Canadian Institutes for Health Research (CIHR) Masters Scholarship, Killam Scholarship, Dalhousie Faculty of Graduate Studies Research and Innovation Award, Nova Scotia Health Research Foundation Scotia Scholars Doctoral award, and the Dalhousie School of Nursing Electa Maclennan Memorial Scholarship; Benoit is supported by a Canadian Institutes of Health Research Vanier Canada Graduate Scholarship, Canadian Child Health Clinician Scientist Program Career Enhancement Award, Nova Scotia Health Research Foundation (NSHRF) Scotia Scholar Doctoral Award, Nova Scotia Research and Innovation Doctoral Scholarship, Dalhousie University School of Nursing Doctoral Scholarship, Helen Watson Memorial Scholarship, and IWK Health Centre Ruby Blois Scholarship; Campbell-Yeo is supported by Canadian Institutes of Health Research (CIHR) New Investigator Award and Child Health Clinician Scientist Program Career Development Award.

The institution where the work was performed: IWK Health Centre, Halifax, Nova Scotia, Canada.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: August 22, 2016; accepted for publication: November 13, 2016.

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