scholarly journals Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units

Critical Care ◽  
2009 ◽  
Vol 13 (2) ◽  
pp. 208 ◽  
Author(s):  
Hui Xie ◽  
Jian Kang ◽  
Gary H Mills
2019 ◽  
Vol 50 ◽  
pp. 151191 ◽  
Author(s):  
Fiona Yu ◽  
Deborah Somerville ◽  
Anna King

2017 ◽  
Vol 100 (4) ◽  
pp. 710-719 ◽  
Author(s):  
Christian Enke ◽  
Andrés Oliva y Hausmann ◽  
Felix Miedaner ◽  
Bernhard Roth ◽  
Christiane Woopen

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hattie Catherine Ann Moyes ◽  
Lana MacNaboe ◽  
Kate Townsend

Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.


2007 ◽  
Vol 16 (6) ◽  
pp. 589-598 ◽  
Author(s):  
Mark A. Malesker ◽  
Pamela A. Foral ◽  
Ann C. McPhillips ◽  
Keith J. Christensen ◽  
Julie A. Chang ◽  
...  

Background The efficiency of protocols for tight glycemic control is uncertain despite their adoption in hospitals. Objectives To evaluate the efficiency of protocols for tight glycemic control used in intensive care units. Methods Three separate studies were performed: (1) a third-party observer used a stopwatch to do a time-motion analysis of patients being treated with a protocol for tight glycemic control in 3 intensive care units, (2) charts were retrospectively reviewed to determine the frequency of deviations from the protocol, and (3) a survey assessing satisfaction with and knowledge of the protocol was administered to full-time nurses. Results Time-motion data were collected for 454 blood glucose determinations from 38 patients cared for by 47 nurses. Mean elapsed times from blood glucose result to therapeutic action were 2.24 (SD, 1.67) minutes for hypoglycemia and 10.65 (SD, 3.24) minutes for hyperglycemia. Mean elapsed time to initiate an insulin infusion was 32.56 (SD, 12.83) minutes. Chart review revealed 734 deviations from the protocol in 75 patients; 57% (n = 418) were deviations from scheduled times for blood glucose measurements. The mean number of deviations was approximately 9 per patient. Of 60 nurses who responded to the workload survey, 42 (70%) indicated that the protocol increased their workload; frequency of blood glucose determinations was the most common reason. Conclusions Nurses spend substantial time administering protocols for tight glycemic control, and considerable numbers of deviations occur during that process. Further educational efforts and ongoing assessment of the impact of such protocols are needed.


2014 ◽  
Vol 3 (6) ◽  
pp. 143
Author(s):  
Brett Abbenbroek ◽  
Christine Duffield ◽  
Doug Elliott

Objective: To determine an appropriate survey instrument to evaluate the impact of organizational structures on the work environment of intensive care nurses. Background: Internationally the demand for intensive care is increasing. Solely increasing bed capacity is not sustainable. Large capacity multi-specialty Intensive Care Units are emerging as the preferred organizational model with benefits resulting from optimizing operational synergies and economies of scale. The impact of this organizational transition on intensive care nurses is not well understood. An appropriate survey instrument for intensive care nurses is required. Design: Integrative literature review. Data Sources: CINAHL, PubMed, EMBASE and OVID Nursing databases searched for studies published between 2005 and 2013. Review methods: An integrative review and quality assessment of the studies was undertaken to select nurse outcome measures associated with organizational structures across a range of acute and critical care settings. Congruence between nurse outcome measures and nurse survey instruments tested in the literature was assessed to select instruments for further psychometric evaluation. Results: Thirty-one cross sectional quantitative studies, from fourteen countries, were reviewed. Twenty one nurse outcome measures associated with organizational factors were identified and a total of twenty five survey instruments used in the studies reviewed. Assessment of congruence and psychometric properties determined that a combination of two instruments is required to comprehensively assess the organizational environment of nurses working in intensive care units. Conclusion: The environment of nurses working in intensive care is effectively evaluated with an instrument that combines subscales from the Practice Environment Scale-Nurse Work Index and Maslach’s Burnout Inventory. 


2013 ◽  
Vol 1 (1) ◽  
pp. 8-17
Author(s):  
Mohammad Omar Faruq ◽  
ASM Areef Ahsan ◽  
Mirza Nazim Uddin ◽  
UH Shahera Khatun ◽  
Md Abdul Mannan ◽  
...  

Objective: To assess compliance of Intensive Care Units (ICUs) of Bangladesh to the components of resuscitation & management bundles of Surviving Sepsis Campaign (SSC). Secondary objective was to assess the impact of compliance on mortality and to determine how its compliance & mortality compared with other Asian and Western countries. Design: Prospective Cohort study. Setting: 14 ICUs of Bangladesh. Participants: 65 adult patients with severe sepsis admitted into these ICUs in July 2009. The organizational characteristics of the participating centers, the patients’ baseline characteristics, the achievement of target within the resuscitation & management bundle & outcome data were recorded. Outcome: Compliance with the Surviving Sepsis Campaign’s resuscitation (6 hrs) & management (24 hrs) bundles. Results: Hospital mortality in ICU patients of Bangladesh suffering from severe sepsis was 49·2%. It was significantly higher than countries reported. Compliance to entire components of both resuscitation & management bundles were reported to be zero in ICUs of Bangladesh. Compliance of individual components of the bundles did not predict improved survival. Conclusion: In ICUs of Bangladesh, high mortality of severe sepsis and failure of compliance of SSC bundle guidelines to have positive impact on survival were presumably attributed to delayed diagnosis, poor adherence to & delayed application of SSC guidelines on sepsis bundles. DOI: http://dx.doi.org/10.3329/bccj.v1i1.14359 Bangladesh Crit Care J March 2013; 1: 8-17


2020 ◽  
Vol 41 (22) ◽  
pp. 2092-2112 ◽  
Author(s):  
J M Pericàs ◽  
M Hernandez-Meneses ◽  
T P Sheahan ◽  
E Quintana ◽  
J Ambrosioni ◽  
...  

Abstract The COVID-19 pandemic has greatly impacted the daily clinical practice of cardiologists and cardiovascular surgeons. Preparedness of health workers and health services is crucial to tackle the enormous challenge posed by SARS-CoV-2 in wards, operating theatres, intensive care units, and interventionist laboratories. This Clinical Review provides an overview of COVID-19 and focuses on relevant aspects on prevention and management for specialists within the cardiovascular field.


2019 ◽  
Vol 40 (9) ◽  
pp. 1056-1058
Author(s):  
Jacob W. Pierce ◽  
Andrew Kirk ◽  
Kimberly B. Lee ◽  
John D. Markley ◽  
Amy Pakyz ◽  
...  

AbstractAntipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.


2020 ◽  
Author(s):  
Poonam Gupta ◽  
Mincy Shaji ◽  
Aisha Amer ◽  
Sherin Joseph ◽  
Ivy Louis ◽  
...  

Abstract Background: Excessive noise is a significant problem for patients in intensive care units (ICUs) and is associated with significant psychological effects and the potential to affect patient outcomes. The noise level in our coronary care intensive unit of a cardiac hospital was found to be approximately 80 dB, which exceeded the international recommended level of 35 dB. We sought to review the causes of this excess noise and the effects of an implementation of quiet time and a noise-reduction bundle in the ICU.Methods: A quality improvement initiative was undertaken to solve the noise issue. A multi-disciplinary team was formed and a number of changes were tested. We used a model for improvement, and the changes were tested using small Plan-Do-Study-Act cycles. Two blocks of quiet time (3-4 pm and 2-4 am) were designated as quiet times during which the lights were dimmed, noise-reduction strategies in the form of a bundle were implemented, and procedures were minimized. In addition, educational material and information were disseminated to physicians, nurses, physical therapists, and other potential individuals who might be affected by the changes that were implemented. Quantitative baseline data was collected using sound meter readings three times a day. Qualitative feedback was collected through staff and patient surveys.Results: During quiet hours, the noise level averaged 22 dB—a decrease from 85 dB. One-hundred patients were surveyed and asked for their feedback concerning quiet time: approximately 97% of them were satisfied with the results.Conclusions: It is possible to reduce noise levels in ICUs by implementing simple and effective measures. This reduction has a significant effect on patient satisfaction, and, in addition, promotes healing.


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