Ryan Kevin M, Gagnon Matthew, Hanna Tyler, Mello Brad, Fofana Mustapha, Ciottone Gregory, Molloy Michael
1Beth Israel Deaconess Medical Center,Department of Emergency Medicine,Boston,MassachusettsUSA.
2Worcester Polytechnic Institute,Department of Mechanical Engineering,Worcester,MassachusettsUSA.
Prehosp Disaster Med. 2016 Aug;31(4):432-5. doi: 10.1017/S1049023X16000388. Epub 2016 May 23.
Introduction Hospitals are meant to be places for respite and healing; however, technological advances and reliance on monitoring alarms has led to the environment becoming increasingly noisy. The coronary care unit (CCU), like the emergency department, provides care to ill patients while being vulnerable to noise pollution. The World Health Organization (WHO; Geneva, Switzerland) recommends that for optimum rest and healing, sound levels should average approximately 30 decibels (dB) with maximum readings less than 40 dB. Problem The purpose of this study was to measure and analyze sound levels in three different locations in the CCU, and to review alarm reports in relation to sound levels.
Over a one-month period, sound recorders (Extech SDL600; Extech Instruments; Nashua, New Hampshire USA) were placed in three separate locations in the CCU at the West Roxbury Veterans' Administration (VA) Hospital (Roxbury, Massachusetts USA). Sound samples were recorded once per second, stored in Comma Separated Values format for Excel (Microsoft Corporation; Redmond, Washington USA), and then exported to Microsoft Excel. Averages were determined, plotted per hour, and alarm histories were reviewed to determine alarm noise effect on total noise for each location, as well as common alarm occurrences.
Patient Room 1 consistently had the lowest average recordings, though all averages were >40 dB, despite decreases between 10:00 pm and 7:00 am. During daytime hours, recordings maintained levels >50 dB. Overnight noise remained above recommended levels 55.25% of the period in Patient Room 1 and 99.61% of the same time period in Patient Room 7. The nurses' station remained the loudest location of all three. Alarms per hour ranged from 20-26 during the day. Alarms per day averaged: Patient Room 1-57.17, Patient Room 7-122.03, and the nurses' station - 562.26. Oxygen saturation alarms accounted for 33.59% of activity, and heart-related (including ST segment and pacemaker) accounted for 49.24% of alarms.
The CCU cares for ill patients requiring constant monitoring. Despite advances in technology, measured noise levels for the hospital studied exceeded WHO standards of 40 dB and peaks of 45 dB, even during night hours when patients require rest. Further work is required to reduce noise levels and examine effects on patient satisfaction, clinical outcomes, and length of stay. Ryan KM , Gagnon M , Hanna T , Mello B , Fofana M , Ciottone G , Molloy M . Noise pollution: do we need a solution? An analysis of noise in a cardiac care unit. Prehosp Disaster Med. 2016;31(4):432-435.
引言 医院本应是让人得到休息和康复的地方；然而，技术进步以及对监测警报的依赖导致医院环境变得越来越嘈杂。冠心病监护病房（CCU）与急诊科一样，在为患病患者提供护理的同时，也容易受到噪音污染的影响。世界卫生组织（WHO；瑞士日内瓦）建议，为了实现最佳的休息和康复，声音水平平均应约为30分贝（dB），最高读数应低于40 dB。问题 本研究的目的是测量和分析冠心病监护病房三个不同位置的声音水平，并审查与声音水平相关的警报报告。
在一个月的时间里，将声音记录仪（Extech SDL600；Extech Instruments；美国新罕布什尔州纳舒厄）放置在美国马萨诸塞州罗克斯伯里市西罗克斯伯里退伍军人管理局（VA）医院冠心病监护病房的三个不同位置。每秒记录一次声音样本，以逗号分隔值格式存储以便于Excel（美国华盛顿州雷德蒙德市微软公司）使用，然后导出到微软Excel。确定平均值，按小时绘制图表，并审查警报历史记录，以确定每个位置警报噪声对总噪声的影响以及常见警报发生情况。
1号病房的平均记录始终最低，尽管所有平均值均>40 dB，尽管在晚上10点至早上7点之间有所下降。在白天，记录保持在>50 dB的水平。在1号病房，夜间噪声在该时间段内有55.25%的时间高于推荐水平，在7号病房同一时间段内则有99.61%的时间高于推荐水平。护士站仍然是所有三个位置中最嘈杂的。白天每小时的警报次数在20 - 26次之间。每天的平均警报次数为：1号病房 - 57.17次，7号病房 - 122.03次，护士站 - 562.26次。血氧饱和度警报占活动的33.59%，与心脏相关的（包括ST段和起搏器）警报占49.24%。
冠心病监护病房护理需要持续监测的患病患者。尽管技术有所进步，但所研究医院测量的噪音水平超过了世界卫生组织40 dB的标准以及45 dB的峰值，即使在患者需要休息的夜间也是如此。需要进一步开展工作以降低噪音水平，并研究其对患者满意度、临床结果和住院时间的影响。瑞安·K·M、加尼翁·M、汉纳·T、梅洛·B、福法纳·M、乔托内·G、莫洛伊·M。噪音污染：我们需要解决方案吗？冠心病监护病房噪音分析。院前灾难医学。2016；31(4):432 - 435。
