Identifying Noise Sources & Alarm Hazards in ICUs – Occurrences. Tools to Minimize

Authors

DOI:

https://doi.org/10.56294/saludcyt2022236

Keywords:

Psychological Factors, Intensive Care Unit, Stressors, Health Care Organization, Alarm Hazards, Medical Devices

Abstract

ICU of a hospital is considered to be one of the most stressful and psychologically taxing working places because of the congregation of critically ill and severely injured patients. Patients with any life-threatening illnesses are admitted to the intensive care unit. The objective of ICUs is to assist such patients duly recover by providing them advanced treatment with the skillful application of advanced techniques. ICU is also a place where sophisticated equipment and machinery necessary to supervise and care for a seriously ill patient are strung together to meet the treatment needs of patients without the possibility of neglecting them. Part of the ICU architecture is medical device alarms. Clinical devices and other appliances sound hundreds of alarms per patient per day, creating a dissonance that can overwhelm, distract, and desensitize health care workers as well as patients. The hazards related to excessive noise and clinical alarms were conceived as a project when it was observed that the stress level of patients and care givers increased due to the noise coming out of these alarm systems. A study undertaken in one of the multispecialty Hospitals in Bhubaneswar to find out the possible sources of stress revealed that noise from alarms and other sources were proving to be a source of a hindrance for effective communication and contributing to patients’ stress. The results of our study indicate that behavioral modification alone is not adequate to control excessive noise. There is a need for further research involving the supportive involvement by clinicians, nurses, and paramedic and support staffs, along with effective medical device alarm management, and continuous process improvement methods and training

References

1. Riegel B, Ehrenreich D. Psychological aspects of critical care nursing. Rockville, Md.: Aspen Publishers; 1989.

2. Molter NC. Needs of relatives of critically ill patients: a descriptive study. Heart Lung 1979;8:332–9.

3. Blacher RS. The psychological and psychiatric consequences of the ICU stay. Eur J Anaesthesiol Suppl 1997;15:45–7. https://doi.org/10.1097/00003643-199705001-00009.

4. Srivastava M. Planning And Design Considerations Of ICU. Technichal Paper SHAPE 95 Section II; 1995.

5. Malkin J. Hospital Interior Architecture: Creating Healing Environments for Special Patient Populations. New York: Jon Wiley Sons; 1992.

6. Putsep E. Modern hospital: international planning practices. London: Lloyd-Luke; 1979.

7. Miliard M. ECRI’s top health tech hazards for 2020 include EHR errors, alert fatigue, missing MRI data. Healthcare IT News 2019. https://www.healthcareitnews.com/news/ecris-top-health-tech-hazards-2020-include-ehr-errors-alert-fatigue-missing-mri-data

8. Kahn DM, Cook TE, Carlisle CC, Nelson DL, Kramer NR, Millman RP. Identification and modification of environmental noise in an ICU setting. Chest 1998;114:535–40. https://doi.org/10.1378/chest.114.2.535.

9. Mistraletti G, Umbrello M, Anania S, Andrighi E, DI Carlo A, Martinetti F, et al. Neurological assessment with validated tools in general ICU: multicenter, randomized, before and after, pragmatic study to evaluate the effectiveness of an e-learning platform for continuous medical education. Minerva Anestesiol 2017;83:145–54. https://doi.org/10.23736/S0375-9393.16.11103-4.

10. Sykes MK, Vickers MD, Hull CJ. Principles of measurement and monitoring in anaesthesia and intensive care. London: Blackwells; 1991.

11. Meredith C, Edworthy J. Are there too many alarms in the intensive care unit? An overview of the problems. J Adv Nurs 1995;21:15–20. https://doi.org/10.1046/j.1365-2648.1995.21010015.x.

12. O’Carroll TM. Survey of alarms in an intensive therapy unit. Anaesthesia 1986;41:742–4. https://doi.org/10.1111/j.1365-2044.1986.tb12844.x.

13. The hazards of alarm overload. Keeping excessive physiologic monitoring alarms from impeding care. Health Devices 2007;36:73–83.

14. Kowalczyk L. MGH death spurs review of patient monitors. The Boston Globe 2010.

15. Kang J. Urban Sound Environment. London: CRC Press; 2006. https://doi.org/10.1201/9781482265613.

16. Khanna A. A study of Intensive Care facilities in Command Hospital, Ruby Hall and Sassoon General Hospital. Pune: University of Poona; 1993.

17. Berglund B, Lindvall T, Schwela DH, Team WHOO and EH. Guidelines for community noise. Geneva: World Health Organization; 1999.

18. Qutub HO, El-Said KF. Assessment of ambient noise levels in the intensive care unit of a university hospital. J Family Community Med 2009;16:53–7.

19. Simons KS, Verweij E, Lemmens PMC, Jelfs S, Park M, Spronk PE, et al. Noise in the intensive care unit and its influence on sleep quality: a multicenter observational study in Dutch intensive care units. Crit Care 2018;22:250. https://doi.org/10.1186/s13054-018-2182-y.

20. McIntyre JWR, Nelson TM. Application of automated human voice delivery to warning devices in an intensive care unit: A laboratory study. J Clin Monit Comput 1989;6:255–62. https://doi.org/10.1007/BF01733631.

21. Al-Samsam RH, Cullen P. Sleep and adverse environmental factors in sedated mechanically ventilated pediatric intensive care patients. Pediatr Crit Care Med 2005;6:562–7. https://doi.org/10.1097/01.pcc.0000165561.40986.a6.

22. Snyder-Halpern R. The effect of critical care unit noise on patient sleep cycles. CCQ 1985;7:41–51.

23. Buemi M, Allegra A, Grasso F, Mondio G. Noise pollution in an intensive care unit for nephrology and dialysis. Nephrol Dial Transplant 1995;10:2235–9. https://doi.org/10.1093/ndt/10.12.2235.

24. Volicer BJ, Isenberg MA, Burns MW. Medical-surgical differences in hospital stress factors. J Human Stress 1977;3:3–13. https://doi.org/10.1080/0097840X.1977.9936082.

25. Ballard KS. Identification of environmental stressors for patients in a surgical intensive care unit. Issues Ment Health Nurs 1981;3:89–108. https://doi.org/10.3109/01612848109140863

Downloads

Published

2022-12-31

How to Cite

1.
Dash S. Identifying Noise Sources & Alarm Hazards in ICUs – Occurrences. Tools to Minimize. Salud, Ciencia y Tecnología [Internet]. 2022 Dec. 31 [cited 2024 Nov. 21];2:236. Available from: https://sct.ageditor.ar/index.php/sct/article/view/53