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重症监护病房声压级和声源的特征:一项为期1周的观察性研究。

Characterization of sound pressure levels and sound sources in the intensive care unit: a 1 week observational study.

作者信息

Naef Aileen C, Knobel Samuel E J, Ruettgers Nicole, Rossier Marilyne, Jeitziner Marie-Madlen, Zante Bjoern, Müri René M, Schefold Joerg C, Nef Tobias, Gerber Stephan M

机构信息

Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Murtenstrasse, Bern, Switzerland.

Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern, Switzerland.

出版信息

Front Med (Lausanne). 2023 Jul 13;10:1219257. doi: 10.3389/fmed.2023.1219257. eCollection 2023.

Abstract

BACKGROUND

Exposure to elevated sound pressure levels within the intensive care unit is known to negatively affect patient and staff health. In the past, interventions to address this problem have been unsuccessful as there is no conclusive evidence on the severity of each sound source and their role on the overall sound pressure levels. Therefore, the goal of the study was to perform a continuous 1 week recording to characterize the sound pressure levels and identify negative sound sources in this setting.

METHODS

In this prospective, systematic, and quantitative observational study, the sound pressure levels and sound sources were continuously recorded in a mixed medical-surgical intensive care unit over 1 week. Measurements were conducted using four sound level meters and a human observer present in the room noting all sound sources arising from two beds.

RESULTS

The mean 8 h sound pressure level was significantly higher during the day (52.01 ± 1.75 dBA) and evening (50.92 ± 1.66 dBA) shifts than during the night shift (47.57 ± 2.23; (2, 19) = 11.80,  < 0.001). No significant difference was found in the maximum and minimum mean 8 h sound pressure levels between the work shifts. However, there was a significant difference between the two beds in the based on location during the day ((3, 28) = 3.91,  = 0.0189) and evening ((3, 24) = 5.66,  = 0.00445) shifts. Cleaning of the patient area, admission and discharge activities, and renal interventions (e.g., dialysis) contributed the most to the overall sound pressure levels, with staff talking occurring most frequently.

CONCLUSION

Our study was able to identify that continuous maintenance of the patient area, patient admission and discharge, and renal interventions were responsible for the greatest contribution to the sound pressure levels. Moreover, while staff talking was not found to significantly contribute to the sound pressure levels, it was found to be the most frequently occurring activity which may indirectly influence patient wellbeing. Overall, identifying these sound sources can have a meaningful impact on patients and staff by identifying targets for future interventions, thus leading to a healthier environment.

摘要

背景

重症监护病房内暴露于高强度声压水平已知会对患者和医护人员的健康产生负面影响。过去,解决这一问题的干预措施并不成功,因为对于每个声源的严重程度及其对总体声压水平的作用尚无确凿证据。因此,本研究的目的是进行连续1周的记录,以表征声压水平并识别该环境中的负面声源。

方法

在这项前瞻性、系统性和定量观察性研究中,在一个综合内科-外科重症监护病房连续1周记录声压水平和声源。使用四个声级计进行测量,并由一名在房间内的观察员记录来自两张病床的所有声源。

结果

白天(52.01±1.75 dBA)和傍晚(50.92±1.66 dBA)班次的平均8小时声压水平显著高于夜班(47.57±2.23;F(2, 19)=11.80,P<0.001)。各工作班次之间的最大和最小平均8小时声压水平无显著差异。然而,在白天(F(3, 28)=3.91,P=0.0189)和傍晚(F(3, 24)=5.66,P=0.00445)班次,两张病床基于位置存在显著差异。患者区域的清洁、入院和出院活动以及肾脏干预措施(如透析)对总体声压水平的贡献最大,其中医护人员交谈出现的频率最高。

结论

我们的研究能够确定,患者区域的持续维护、患者的入院和出院以及肾脏干预措施对声压水平的贡献最大。此外,虽然未发现医护人员交谈对声压水平有显著贡献,但发现它是最常发生的活动,可能间接影响患者的健康。总体而言,识别这些声源可以通过确定未来干预的目标对患者和医护人员产生有意义的影响,从而营造一个更健康的环境。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6efc/10382019/3a3e05939d8f/fmed-10-1219257-g001.jpg

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