title: Sound levels, staff perceptions, and patient outcomes during renovation near the neonatal intensive care unit.
abstract: OBJECTIVE
  Sound levels, staff perceptions, and patient outcomes were evaluated during a year-long hospital renovation project on the floor above a neonatal intensive care unit (NICU).
  
  
  BACKGROUND
  Construction noise may be detrimental to NICU patients and healthcare professionals. There are no comprehensive studies evaluating the impact of hospital construction on sound levels, staff, and patients.
  
  
  METHODS
  Prospective observational study comparing sound measures and patient outcomes before, during, and after construction. Staff were surveyed about the construction noise, and hospital employee satisfaction scores are reported.
  
  
  RESULTS
  Equivalent sound levels were not significantly higher during construction. Most staff members (89%) perceived the renovation period as louder, and 83% reported interruptions of their work. Patient outcomes were the same or more positive during construction. Very low birth weight (VLBW) infants were less likely to require 24+ hours' mechanical ventilation during construction: 54% vs. 59% before (OR = 1.6, p = 0.018) and 62% after (OR = 1.48, p = 0.065); and they required a shorter total period of mechanical ventilation: 3.6 days vs. 8.0 before (p = 0.011) and 9.5 after (p = 0.001). VLBW newborns' differences in ventilation days were mostly in the upper extremes; medians were similar in all periods: 0.6 days vs. 1 day preconstruction and 2 days postconstruction.
  
  
  CONCLUSIONS
  Construction above the NICU did not cause substantially louder sound levels, but staff perceived important changes in noise and work routines. No evidence suggested that patients were negatively affected by the renovation period. Meticulous construction planning remains necessary to avoid interference with patient care and caregiver work environments.
authors.affiliation: Corresponding Author: Amber W. Trickey, MS, CPH, 6410 Fannin St., Ste 1100, Houston, TX 77030 (AmberL.Williams@uth.tmc.edu).
authors.forename: Amber W
authors.initials: AW
authors.lastname: Trickey
authors.forename: Cody C
authors.initials: CC
authors.lastname: Arnold
authors.forename: Ankit
authors.initials: A
authors.lastname: Parmar
authors.forename: Robert E
authors.initials: RE
authors.lastname: Lasky
mesh_terms: D006749:Hospital Design and Construction; D006801:Humans; D007363:Intensive Care Units, Neonatal; D009622:Noise; D010465:Perception; D011446:Prospective Studies