Crockett Christy J, Nylander Veronica E, Wooten Elizabeth J, Menser Carrie C
Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Paediatr Anaesth. 2022 Nov;32(11):1262-1269. doi: 10.1111/pan.14553. Epub 2022 Sep 15.
Operating room noise levels may hinder staff communication and cause distractions for providers, endangering patient safety. Owing to concerns of unacceptable noise levels during emergence from general anesthesia, our institution developed a quality improvement project. The SMART aim of this initiative was to decrease the average decibel noise level measured during emergence from general anesthesia in our operating rooms from 65.65 to 63 decibels and the maximum decibel noise level from 81.64 to 75 decibels over approximately 3 months.
A multidisciplinary team completed this project utilizing improvement science methodology from The Model for Improvement, including interventions tested via Plan-Do-Study-Act cycles. Data were measured, collected manually, and entered in an Excel spreadsheet. Data were analyzed using statistical process control methods, including a Run Chart. Our measures were the average and maximum decibel noise levels during emergence from general anesthesia.
Several interventions were associated with a decrease in the average and maximum decibel noise levels. Interventions included educational presentations to perioperative staff; the operating room nurse taking the role of pausing any music; and the utilization of an audible and visual decibel alarm meter to sound and blink lights when the noise level is too high. During the initiative, the average (and maximum) decibel noise levels during emergence from general anesthesia in our operating rooms decreased from 65.65 (81.84) to 61.5 (76.44).
This improvement project was associated with a decrease in decibel noise levels during emergence. We enhanced a process and encouraged culture change at an academic pediatric hospital to enhance the safety of our care.
手术室噪音水平可能会妨碍医护人员沟通，分散医护人员注意力，危及患者安全。由于担心全身麻醉苏醒期间噪音水平过高，我们机构开展了一项质量改进项目。该项目的具体目标是在大约3个月内，将我们手术室全身麻醉苏醒期间测得的平均分贝噪音水平从65.65降至63分贝，将最大分贝噪音水平从81.64降至75分贝。
一个多学科团队利用《改进模式》中的改进科学方法完成了该项目，包括通过计划-执行-研究-行动循环测试的干预措施。数据通过人工测量、收集并录入Excel电子表格。使用统计过程控制方法（包括运行图）对数据进行分析。我们的测量指标是全身麻醉苏醒期间的平均和最大分贝噪音水平。
多项干预措施与平均和最大分贝噪音水平的降低有关。干预措施包括对围手术期工作人员进行教育讲座；手术室护士负责暂停播放任何音乐；以及在噪音水平过高时使用可听可视的分贝警报仪发出声音并闪烁灯光。在该项目实施期间，我们手术室全身麻醉苏醒期间的平均（和最大）分贝噪音水平从65.65（81.84）降至61.5（76.44）。
该改进项目与苏醒期间分贝噪音水平的降低有关。我们在一家学术性儿科医院改进了流程并鼓励文化变革，以提高我们护理工作的安全性。
