Gabrysch Caroline Helena, Anders Sophie-Isabelle, Dressler-Steinbach Iris, Braun Thorsten, Efe Ilhamiyya, Henrich Wolfgang
Department of Obstetrics and Perinatology, Charité Universitätsmedizin Berlin, Berlin, Germany.
Department of Gynecology, Universitätsklinikum Jena, Jena, Germany.
Birth. 2025 Mar;52(1):157-166. doi: 10.1111/birt.12878. Epub 2024 Nov 1.
Noise reduction during surgical procedures leads to improved surgical performance and results. The caesarean birth (CB) is an exceptional operation and a life changing experience. Through the introduction of staff education and implementation of audiovisual feedback, we intended to reduce noise, and subsequently reduce surgical complications and increase the well-being of patients and staff.
During Phase I, blinded baseline measurements of noise were conducted. Phase II started after staff education and structured questionnaires on subjective noise and stress were added, and in Phase III audiovisual feedback was introduced. Mean and peak noise levels over the time of the procedure were obtained in A-weighted decibels (dB(A)). Kruskal-Wallis H tests were performed to evaluate the impact of interventions on noise levels. Questionnaires were evaluated using descriptive statistics; stress-scores were compared using independent sample t-tests.
Ninety planned CBs were included. Median noise levels were 62.85 dB(A) at baseline. They decreased significantly to 60.60 dB(A) (Phase II) and 59.25 dB(A) (Phase III), respectively. This reduction of 3.6 dB(A) leads to a subjective noise reduction of around 20%. Significant differences for A-weighted and peak noise levels during actual surgery were found after combining staff education with audiovisual feedback. In Phase III, staff reported less stressful noise. Stress also decreased significantly in the patient group. Beeping machines and telephones were identified as the most stressful sources of noise.
We show that noise reduction during CB is both necessary and possible. Diminished subjective perception of noise and stress are positive impacts of this intervention. Staff education and audiovisual feedback can help to provide a calm and lower stress environment for patients and staff during caesarean births.
手术过程中降低噪音可提高手术表现及效果。剖宫产是一项特殊手术，会改变人的生活。通过开展员工培训并实施视听反馈，我们旨在降低噪音，进而减少手术并发症，提升患者及医护人员的幸福感。
在第一阶段，对噪音进行了盲法基线测量。第二阶段在员工培训后开始，并增加了关于主观噪音和压力的结构化问卷，第三阶段引入了视听反馈。手术过程中的平均和峰值噪音水平以A加权分贝（dB(A)）获取。进行Kruskal-Wallis H检验以评估干预措施对噪音水平的影响。问卷采用描述性统计进行评估；压力得分使用独立样本t检验进行比较。
纳入了90例计划剖宫产。基线时噪音水平中位数为62.85 dB(A)。分别显著降至60.60 dB(A)（第二阶段）和59.25 dB(A)（第三阶段）。这3.6 dB(A)的降低导致主观噪音降低约20%。将员工培训与视听反馈相结合后，实际手术期间A加权和峰值噪音水平存在显著差异。在第三阶段，工作人员报告压力性噪音减少。患者组的压力也显著降低。蜂鸣器和电话被确定为最具压力的噪音源。
我们表明剖宫产过程中降低噪音既是必要的也是可行的。噪音和压力主观感受的减轻是该干预措施的积极影响。员工培训和视听反馈有助于在剖宫产过程中为患者和工作人员提供一个平静、压力较小的环境。
