title: Levels and sources of sound in the intensive care unit - an observational study of three room types.
abstract: BACKGROUND
  Many intensive care unit (ICU) patients describe noise as stressful and precluding sleep. No previous study in the adult setting has investigated whether room size impacts sound levels or the frequency of disruptive sounds.
  
  
  METHODS
  A-frequency S-time weighted equivalent continuous sound (LAS eq), A-frequency S-time weighted maximum sound level (LAS max) and decibel C peak sound pressure (LC peak) were measured during five 24-h periods in each of the following settings: three-bed room with nursing station (NS) alcove, single-bed room with NS alcove (1-BR with NSA) and single-bed room with bedside NS. Cumulative restorative time (CRT) (> 5 min with LAS max < 55 dB and LC peak < 75 dB) was calculated to describe calm periods. Two 8-h bedside observations were performed in each setting in order to note the frequency and sources of disruptive sounds.
  
  
  RESULTS
  Mean sound pressure levels (LAS eq) ranged between 52 and 58 dBA, being lowest during night shifts. There were no statistically significant differences between the room types in mean sound levels or in CRT. However, disruptive sounds were 40% less frequent in the 1-BR with NSA than in the other settings. Sixty-four percent of disruptive sounds were caused by monitor alarms and conversations not related to patient care.
  
  
  CONCLUSIONS
  Single-bed rooms do not guarantee lower sound levels per se but may imply less frequent disruptive sounds. Sixty-four percent of disruptive sounds were avoidable. Our findings warrant sound reducing strategies for ICU patients.
authors.affiliation: Department of Anesthesiology, Surgical Sciences and Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Tegnestedt
authors.forename: A
authors.initials: A
authors.lastname: Günther
authors.forename: A
authors.initials: A
authors.lastname: Reichard
authors.forename: R
authors.initials: R
authors.lastname: Bjurström
authors.forename: J
authors.initials: J
authors.lastname: Alvarsson
authors.forename: C-R
authors.initials: CR
authors.lastname: Martling
authors.forename: P
authors.initials: P
authors.lastname: Sackey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005160:Facility Design and Construction; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007362:Intensive Care Units / Q000458:organization & administration*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009622:Noise; D063187:Nursing Stations / Q000458:organization & administration; D010865:Pilot Projects; D013016:Sound; D013997:Time Factors; D012122:Ventilators, Mechanical; D016526:Workload; D055815:Young Adult