Department of Obstetrics and Gynecology, HEH-Horsens Regional Hospital, Horsens, Denmark.
Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
PLoS One. 2019 Aug 30;14(8):e0221860. doi: 10.1371/journal.pone.0221860. eCollection 2019.
We aimed to investigate whether noise in delivery rooms is associated with impaired performance of obstetric teams managing major (≥1000 mL) postpartum hemorrhage.
We included video recordings of 96 obstetric teams managing real-life major postpartum hemorrhage. Exposure was noise defined as the occurrence of sound level pressures (SPL) above 90 dB. The outcome was high clinical performance assessed through expert ratings using the TeamOBS-PPH tool.
The 23 teams unexposed to noise had a significantly higher chance of high clinical performance than the 73 teams exposed to noise: 91.3% (95% CI; 72.0-98.9) versus 58.9% (95% CI; 46.8-70.3) (p < 0.001). The results remained significant when adjusting for the following possible confounders: team size, non-technical performance, bleeding velocity, hospital type, etiology of bleeding, event duration and time of day. Typical sources of noise above 90 dB SPL were mother or baby crying, dropping of instruments, and slamming of cupboard doors.
Noise in delivery rooms may be an independent source of impaired clinical performance.
我们旨在研究产房噪音是否与管理大量（≥1000 毫升）产后出血的产科团队表现受损有关。
我们纳入了 96 个管理真实大量产后出血的产科团队的视频记录。暴露因素为噪音，定义为声压级（SPL）超过 90 分贝。结果是通过使用 TeamOBS-PPH 工具进行专家评估得出的高临床表现。
未暴露于噪音的 23 个团队比暴露于噪音的 73 个团队具有更高的高临床表现机会：91.3%（95%CI；72.0-98.9）比 58.9%（95%CI；46.8-70.3）（p<0.001）。当调整以下可能的混杂因素时，结果仍然显著：团队规模、非技术表现、出血速度、医院类型、出血原因、事件持续时间和一天中的时间。超过 90 分贝 SPL 的典型噪音源是母亲或婴儿的哭声、器械掉落和橱柜门的摔打声。
产房中的噪音可能是临床表现受损的一个独立来源。
