Jennifer Moore, med-surg unit secretary and certified nursing assistant, and Debbie Toner, RN, clinical coordinator, keep their voices low near the TalkLight.
On a quest to provide a more restful setting for patients to recuperate and a calmer workplace for staff, the 1A medical-surgical unit at Bayhealth Medical Center's Kent General Hospital in Dover, Del., installed the TalkLight, a sound-level meter that looks like a traffic light.
"It's really important we have a calm, healing environment for patients, and this is one way we could work on that," says Jeanne Nichols-Willey, RN, BSN, clinical practice leader on 1A, who introduced the idea after learning about the TalkLight from a fellow student in her master's program.
A steady green glow indicating low levels of noise turns to a flashing yellow as noise levels rise and then to red with an audible alert when the unit becomes too raucous. The TalkLight's settings are programmed to be more sensitive to noise during the nighttime hours.
"Even if people were talking quietly, the noise level quickly became out of hand," Nichols-Willey says, explaining why the device was needed. "The TalkLight gives us a gentle reminder with the flashing yellow light that the noise level was creeping up, or the red light followed by a beep."
Staff remind each other to quiet down when the yellow light flashes.
"It's a fun thing," says Dianne Halpern, RN, MSN, nurse manager of 1A, a 30-bed unit with the rooms surrounding a central nursing station. "[The TalkLight] catches everyone's eye when they are walking onto the unit. It's a great conversation piece."
And patients notice a difference.
"If it's a quiet day, patients will say they rested comfortably and didn't hear things," Nichols-Willey says.
"It's really important we have a calm, healing environment for patients, and this is one way we could work on that," says Jeanne Nichols-Willey, RN, BSN, clinical practice leader on 1A, who introduced the idea after learning about the TalkLight from a fellow student in her master's program.
A steady green glow indicating low levels of noise turns to a flashing yellow as noise levels rise and then to red with an audible alert when the unit becomes too raucous. The TalkLight's settings are programmed to be more sensitive to noise during the nighttime hours.
"Even if people were talking quietly, the noise level quickly became out of hand," Nichols-Willey says, explaining why the device was needed. "The TalkLight gives us a gentle reminder with the flashing yellow light that the noise level was creeping up, or the red light followed by a beep."
Staff remind each other to quiet down when the yellow light flashes.
"It's a fun thing," says Dianne Halpern, RN, MSN, nurse manager of 1A, a 30-bed unit with the rooms surrounding a central nursing station. "[The TalkLight] catches everyone's eye when they are walking onto the unit. It's a great conversation piece."
And patients notice a difference.
"If it's a quiet day, patients will say they rested comfortably and didn't hear things," Nichols-Willey says.
Evidence Supports Quiet Units
The 2007 "Sound Control for Improved Outcomes in Healthcare Settings" report from the Center for Health Design in Concord, Calif., concluded high ambient noise levels affect patients' sleep and blood pressure and contribute to staff exhaustion. In addition, the report says a poor acoustical environment impedes communication between patients and staff and between staff members by rendering speech and auditory signals less intelligible or detectable, which has serious implications for patient safety.
Johns Hopkins University in Baltimore released a report in 2005 indicating a dramatic increase in hospital noise. Acoustical engineers began with noise measurements in several patient areas at Johns Hopkins and then surveyed published reports on noise in hospitals around the world. The study found that since 1960, sound levels in hospitals had risen from an average 57 decibels during the day in 1960 to 72 decibels. At night the levels jumped from 42 decibels in 1960 to 60 decibels.
Researchers found that much of the noise fell into the human speech frequency range. And as levels rose, doctors and nurses had to speak even louder to be heard, perpetuating the escalation in noise levels.
The 2007 "Sound Control for Improved Outcomes in Healthcare Settings" report from the Center for Health Design in Concord, Calif., concluded high ambient noise levels affect patients' sleep and blood pressure and contribute to staff exhaustion. In addition, the report says a poor acoustical environment impedes communication between patients and staff and between staff members by rendering speech and auditory signals less intelligible or detectable, which has serious implications for patient safety.
Johns Hopkins University in Baltimore released a report in 2005 indicating a dramatic increase in hospital noise. Acoustical engineers began with noise measurements in several patient areas at Johns Hopkins and then surveyed published reports on noise in hospitals around the world. The study found that since 1960, sound levels in hospitals had risen from an average 57 decibels during the day in 1960 to 72 decibels. At night the levels jumped from 42 decibels in 1960 to 60 decibels.
Researchers found that much of the noise fell into the human speech frequency range. And as levels rose, doctors and nurses had to speak even louder to be heard, perpetuating the escalation in noise levels.
How Loud Is Too Loud?
The World Health Organization's 1995 hospital-noise guidelines recommend that sound levels not exceed 35 decibels.
The article "Noise Control: A Nursing Team's Approach to Sleep Promotion," which appeared in the February 2004 American Journal of Nursing, offers these noise-level comparisons as a frame of reference:
• Heavy truck traffic: 80 decibels
• Conversational speech: 60 decibels
• Quiet woodland: 30 decibels
The authors, who are members of a sleep promotion team at Mayo Clinic-affiliated St. Mary's Hospital in Rochester, Minn., indicate that noise can produce damaging psychophysiologic effects, such as stress, delayed healing, impaired immune function, and increased blood pressure and heart rate.
The World Health Organization's 1995 hospital-noise guidelines recommend that sound levels not exceed 35 decibels.
The article "Noise Control: A Nursing Team's Approach to Sleep Promotion," which appeared in the February 2004 American Journal of Nursing, offers these noise-level comparisons as a frame of reference:
• Heavy truck traffic: 80 decibels
• Conversational speech: 60 decibels
• Quiet woodland: 30 decibels
The authors, who are members of a sleep promotion team at Mayo Clinic-affiliated St. Mary's Hospital in Rochester, Minn., indicate that noise can produce damaging psychophysiologic effects, such as stress, delayed healing, impaired immune function, and increased blood pressure and heart rate.
Noise-Reduction Strategies
The Mayo nurses measured noise levels on their surgical thoracic intermediate care unit and found peak levels as high as 113 decibels at night, with the highest peaks and longest-lasting peaks occurring during change of shift. As a result, the nurses began an interdisciplinary education campaign and gathered ideas for reducing noise. They focused on speaking quietly, using the shift-report room, routinely closing doors to patient rooms, eliminating overhead paging at night, and modifying equipment to make it quieter. Post-intervention, the nurses found peak levels during shift change were down to 86 decibels on the night shift.
Likewise, when a nurse at Montefiore Medical Center in Bronx, N.Y., investigated noise levels, she found decibels at a peak of 78 before implementing a Silent Hospitals Help Healing (SHHH) noise-reduction program. Within two weeks of squeaky carts sent for lubrication, staff switching beepers to vibrate, intercoms turned down, and managers monitoring hallway conversations, patients reported they were sleeping better, the staff said they felt less stressed, and peak noise levels dropped to between 50 and 60 decibels.
The Mayo nurses measured noise levels on their surgical thoracic intermediate care unit and found peak levels as high as 113 decibels at night, with the highest peaks and longest-lasting peaks occurring during change of shift. As a result, the nurses began an interdisciplinary education campaign and gathered ideas for reducing noise. They focused on speaking quietly, using the shift-report room, routinely closing doors to patient rooms, eliminating overhead paging at night, and modifying equipment to make it quieter. Post-intervention, the nurses found peak levels during shift change were down to 86 decibels on the night shift.
Likewise, when a nurse at Montefiore Medical Center in Bronx, N.Y., investigated noise levels, she found decibels at a peak of 78 before implementing a Silent Hospitals Help Healing (SHHH) noise-reduction program. Within two weeks of squeaky carts sent for lubrication, staff switching beepers to vibrate, intercoms turned down, and managers monitoring hallway conversations, patients reported they were sleeping better, the staff said they felt less stressed, and peak noise levels dropped to between 50 and 60 decibels.
Other Bayhealth Tactics
Bayhealth also is taking a multipronged approach to addressing high noise levels. In addition to installing the $190 TalkLight, the hospital is investigating the installation of ceiling panels designed to reduce noise pollution in patient rooms. The panels are in one room as a trial.
Bayhealth also installed a wireless telephone and messaging system, which eliminates most overhead pages. When a patient presses the call bell, the nurse is notified by telephone. Staff members now communicate with one another by phone, rather than yelling to each other across the station. Discussions about noise reduction take place at every monthly staff meeting.
"The TalkLight works because our nursing staff cares," Nichols-Willey says. "They care about the environment and patients getting rest. If they didn't care, the TalkLight wouldn't work."
Bayhealth also is taking a multipronged approach to addressing high noise levels. In addition to installing the $190 TalkLight, the hospital is investigating the installation of ceiling panels designed to reduce noise pollution in patient rooms. The panels are in one room as a trial.
Bayhealth also installed a wireless telephone and messaging system, which eliminates most overhead pages. When a patient presses the call bell, the nurse is notified by telephone. Staff members now communicate with one another by phone, rather than yelling to each other across the station. Discussions about noise reduction take place at every monthly staff meeting.
"The TalkLight works because our nursing staff cares," Nichols-Willey says. "They care about the environment and patients getting rest. If they didn't care, the TalkLight wouldn't work."
Debra Anscombe Wood, RN, is a freelance writer.To comment, e-mail editorPA@nursingspectrum.com.
