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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

Average noise levels in the first four days. Means and 95-% confidence intervals are shown for LAeq averaged over 22 patients. Daytime was defined to be between 7 am and 9 pm (therefore, LAeq,14h for daytime, LAeq,10h for nighttime).
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Fig3: Average noise levels in the first four days. Means and 95-% confidence intervals are shown for LAeq averaged over 22 patients. Daytime was defined to be between 7 am and 9 pm (therefore, LAeq,14h for daytime, LAeq,10h for nighttime).

Mentions: Figure 3 shows the trends of the average noise level since the patients’ admission to the ICU. For the daytime average, the noise level decreased from Day 1 to Day 2 by ~0.5 dB, and then increased to Day 3 and 4, although the range of the overall change was only within ~1 dB. On the other hand, the nighttime average generally decreased from Day 1 to Day 4 in the range of ~1.5 dB. A two-way repeated-measure ANOVA indicated that the effect of day was significant [ F(3,63)=3.404; p=.023], and so was that of the time of day [day/night; F(1,21)=96.5; p<.001]. A post-hoc analysis was carried out by comparing Day 1 to Day 2 and Day 2 to Day 4 based on paired t-tests, which showed that the average noise level on Day 1 differed from Day 2 during the nighttime (p=.008), and Day 2 from Day 4 during the daytime (p=.005), which were significant with an appropriate Bonferroni correction (p<.025).Figure 3


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)

Average noise levels in the first four days. Means and 95-% confidence intervals are shown for LAeq averaged over 22 patients. Daytime was defined to be between 7 am and 9 pm (therefore, LAeq,14h for daytime, LAeq,10h for nighttime).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Average noise levels in the first four days. Means and 95-% confidence intervals are shown for LAeq averaged over 22 patients. Daytime was defined to be between 7 am and 9 pm (therefore, LAeq,14h for daytime, LAeq,10h for nighttime).
Mentions: Figure 3 shows the trends of the average noise level since the patients’ admission to the ICU. For the daytime average, the noise level decreased from Day 1 to Day 2 by ~0.5 dB, and then increased to Day 3 and 4, although the range of the overall change was only within ~1 dB. On the other hand, the nighttime average generally decreased from Day 1 to Day 4 in the range of ~1.5 dB. A two-way repeated-measure ANOVA indicated that the effect of day was significant [ F(3,63)=3.404; p=.023], and so was that of the time of day [day/night; F(1,21)=96.5; p<.001]. A post-hoc analysis was carried out by comparing Day 1 to Day 2 and Day 2 to Day 4 based on paired t-tests, which showed that the average noise level on Day 1 differed from Day 2 during the nighttime (p=.008), and Day 2 from Day 4 during the daytime (p=.005), which were significant with an appropriate Bonferroni correction (p<.025).Figure 3

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