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The influence of APACHE II score on the average noise level in an intensive care unit: an observational study.

Park M, Vos P, Vlaskamp BN, Kohlrausch A, Oldenbeuving AW - BMC Anesthesiol (2015)

Bottom Line: The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events.When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery.Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

View Article: PubMed Central - PubMed

Affiliation: Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands.

ABSTRACT

Background: Noise levels in hospitals, especially in intensive care units (ICUs) are known to be high, potentially affecting not only the patients' well-being but also their clinical outcomes. In an observational study, we made a long-term measurement of noise levels in an ICU, and investigated the influence of various factors on the noise level, including the acute physiology and chronic health evaluation II (APACHE II) score.

Methods: The average noise level was continuously measured for three months in all (eight) patient rooms in an ICU, while the patient data were also registered, including the APACHE II score. The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events. For the patients with LOS ≥4 days, the average noise levels in the first four days were analyzed, and regression models were established using the stepwise search method based on the Akaike information criterion.

Results: Features identified in the 24-hour trends (n = 55) agreed well with the daily routine events in the ICU, where regular check-ups raised the 10-minute average noise level by 2~3 dBA from the surrounding values at night, and the staff shift changes consistently increased the noise level by 3~5 dBA. When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery. Regression analysis showed that the APACHE II score, room location, gender, day of week and the ICU admission type could explain more than 50% of the variance in the daily average noise level, LAeq,24h. Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

Conclusions: Patient's initial health condition is one important factor that influences the acoustic environment in an ICU, which needs to be considered in observational and interventional studies where the noise in healthcare environments is the subject of investigation.

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Related in: MedlinePlus

24-hour trend of the average noise level every 10 minutes (LAeq,10m). The trends were averaged over 55 patients (299 occupied days) and over 134 unoccupied days, respectively. Inverted triangles indicate the time stamps of the daily routine events in the ICU, as listed in Table 1.
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Fig2: 24-hour trend of the average noise level every 10 minutes (LAeq,10m). The trends were averaged over 55 patients (299 occupied days) and over 134 unoccupied days, respectively. Inverted triangles indicate the time stamps of the daily routine events in the ICU, as listed in Table 1.

Mentions: During the measurement period, 55 patients stayed in the ICU for one day or longer, and 24-hour trends were obtained given the 299-day dataset associated with these patients. As shown in Figure 2, LAeq,10m varied throughout the occupied days from 43.8 dB to 55.0 dB on average. Where the daily routine in this particular ICU is summarized in Table 1, the peaks and troughs of the average seem to correspond well to the listed events. For example, regular check-ups took place in the ICU every two hours, which show up in the graph prominently at 2, 4 and 22 o’clock, where the check-ups at 0 and 6 o’clock combined with additional patient-care activities (e.g., doctors’ round or X-ray) raised the noise level noticeably higher than the normal check-ups. When the morning routine began, the average noise level increased by ~10 dBA, quickly reaching the daily maximum at 55 dBA, and then gradually decreased in the next few hours. When the staff coffee break ended at 11am, the noise level returned close to the maximum, again gradually decreasing towards the lunch break. On average, regular check-ups during the nighttime raised LAeq,10m by 2~3 dB from the surrounding values, and similarly the staff shift changes at 7.30, 15.30 and 23 o’clock consistently increased the 10-minute average noise level by 3~5 dB for approximately 20 minutes.Figure 2


The influence of APACHE II score on the average noise level in an intensive care unit: an observational study.

Park M, Vos P, Vlaskamp BN, Kohlrausch A, Oldenbeuving AW - BMC Anesthesiol (2015)

24-hour trend of the average noise level every 10 minutes (LAeq,10m). The trends were averaged over 55 patients (299 occupied days) and over 134 unoccupied days, respectively. Inverted triangles indicate the time stamps of the daily routine events in the ICU, as listed in Table 1.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389973&req=5

Fig2: 24-hour trend of the average noise level every 10 minutes (LAeq,10m). The trends were averaged over 55 patients (299 occupied days) and over 134 unoccupied days, respectively. Inverted triangles indicate the time stamps of the daily routine events in the ICU, as listed in Table 1.
Mentions: During the measurement period, 55 patients stayed in the ICU for one day or longer, and 24-hour trends were obtained given the 299-day dataset associated with these patients. As shown in Figure 2, LAeq,10m varied throughout the occupied days from 43.8 dB to 55.0 dB on average. Where the daily routine in this particular ICU is summarized in Table 1, the peaks and troughs of the average seem to correspond well to the listed events. For example, regular check-ups took place in the ICU every two hours, which show up in the graph prominently at 2, 4 and 22 o’clock, where the check-ups at 0 and 6 o’clock combined with additional patient-care activities (e.g., doctors’ round or X-ray) raised the noise level noticeably higher than the normal check-ups. When the morning routine began, the average noise level increased by ~10 dBA, quickly reaching the daily maximum at 55 dBA, and then gradually decreased in the next few hours. When the staff coffee break ended at 11am, the noise level returned close to the maximum, again gradually decreasing towards the lunch break. On average, regular check-ups during the nighttime raised LAeq,10m by 2~3 dB from the surrounding values, and similarly the staff shift changes at 7.30, 15.30 and 23 o’clock consistently increased the 10-minute average noise level by 3~5 dB for approximately 20 minutes.Figure 2

Bottom Line: The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events.When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery.Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

View Article: PubMed Central - PubMed

Affiliation: Brain, Cognition & Perception Group, Philips Research, High Tech Campus 36, AE Eindhoven, 5656 The Netherlands.

ABSTRACT

Background: Noise levels in hospitals, especially in intensive care units (ICUs) are known to be high, potentially affecting not only the patients' well-being but also their clinical outcomes. In an observational study, we made a long-term measurement of noise levels in an ICU, and investigated the influence of various factors on the noise level, including the acute physiology and chronic health evaluation II (APACHE II) score.

Methods: The average noise level was continuously measured for three months in all (eight) patient rooms in an ICU, while the patient data were also registered, including the APACHE II score. The 24-hour trend of the noise level was obtained for the patients of length-of-stay (LOS) ≥1 day, which was compared to the timeline of the ICU routine events. For the patients with LOS ≥4 days, the average noise levels in the first four days were analyzed, and regression models were established using the stepwise search method based on the Akaike information criterion.

Results: Features identified in the 24-hour trends (n = 55) agreed well with the daily routine events in the ICU, where regular check-ups raised the 10-minute average noise level by 2~3 dBA from the surrounding values at night, and the staff shift changes consistently increased the noise level by 3~5 dBA. When analyzed in alignment with the patient's admission (n=22), the daytime acoustic condition improved from Day 1 to 2, but worsened from Day 2 to 4, most likely in relation to the various phases of patient's recovery. Regression analysis showed that the APACHE II score, room location, gender, day of week and the ICU admission type could explain more than 50% of the variance in the daily average noise level, LAeq,24h. Where these factors were argued to have causal relations to LAeq,24h, the APACHE II score was found to be most strongly correlated: LAeq,24h increased by 1.3~1.5 dB when the APACHE II score increased by 10 points.

Conclusions: Patient's initial health condition is one important factor that influences the acoustic environment in an ICU, which needs to be considered in observational and interventional studies where the noise in healthcare environments is the subject of investigation.

Show MeSH
Related in: MedlinePlus