QIPS TIPS #21: Like a Rockstar!

Shari WelchShari Welch, MD, FACEP

There is a large body of research which provides strong evidence that hospitals are loud environments with noise levels far-exceeding that recommended by the World Health Organization (WHO). WHO guidelines specify 35 decibels (dB) for continuous background noise in patient rooms with nighttime peaks not to exceed 40 dB. Hospital background noise levels exceed those levels and peaks frequently exceed 90 dB. Staff voices and medical equipment typically produce noise at 70-75 dB levels. Other sources of noise include noise from alarms, bedrails, telephones, ice machines, paging systems and pneumatic tube systems. The noise from portable X-ray machines can exceed 90 dB, which is analogous to walking alongside to a highway when a large truck passes.

Noise is neither good for patients or healthcare providers. High ambient noise in patient care areas has been associated with increases in blood pressure, heart rate, and poor sleep patterns. Noise in nurseries has been associated with higher oxygen support therapy needs. Even more alarming, a study of a coronary care unit showed an increase in readmissions following discharge for patients who had poor room acoustics and noisy hospital stays. As the nation’s hospitals prepare for readmission penalties this is something hospital executives might note!

The ED can be a particularly noisy environment and this noise elevates stress in patients.  In one study, real ED patients listening to a digital audio recording of nature sounds, a soothing beat, or acoustical music demonstrated a decrease in anxiety when compared to controls listening to a recording of ED noise.  The prospects for healthcare workers in terms of health and hearing loss are just as grim. Work in high ambient noise settings has been associated with hypertension and coronary artery disease. Noise-induced stress has been identified as a predictor of burnout in critical care nurses. In the ED, noise levels have been identified as stressful and interfere with communication and teaching. High noise levels in a hospital setting have also been associated with hearing loss for varying types of healthcare workers, including physicians.

Let’s face it:  In terms of the toll this loud noise takes on healthcare workers, we might as well have chosen “Rock Star” as a profession!

Stay Tuned for some Ideas on How to Reduce the Noise in the ED!


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