Impact of Noise on Nurses in Pediatric Intensive Care Units.
BACKGROUND
Excessive exposure to noise places nurses at risk for safety events, near-misses, decreased job performance, and fatigue. Noise is particularly a concern in pediatric intensive care units, where highly skilled providers and vulnerable patients require a quiet environment to promote healing.


OBJECTIVE
To measure noise levels and noise duration on specialty pediatric intensive care units to explore sources of noise and its effects on the health of registered nurses.


METHODS
In a cross-sectional pilot study, levels and sources of noise in 3 different specialty pediatric intensive care units were assessed. Fifteen nurses were observed for 4-hour sessions during a 24-hour period. Sound pressure levels (noise) and heart rate were measured continuously, and stress ratings were recorded. Descriptive statistics were calculated for noise (level, source, location, and activity), heart rate, and stress. The Pearson correlation coefficient was calculated to analyze the relationship between heart rate and noise.


RESULTS
Mean noise level was 71.9 (SD, 9.2) dBA. Mean heart rate was 85.2/min (SD, 15.8/min) and was significantly associated with noise, unit, within-unit location, nurse sources, and noise activities. The most frequent sources of noise were patients' rooms, care activities, and staff communications.


CONCLUSIONS
Noise levels in pediatric intensive care units exceed recommended thresholds and require immediate attention through effective interventions. Although noise was not associated with stress, a significant correlation with increased heart rate indicates that noise may be associated with adverse health outcomes.
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
J'ai
J
Watson
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Angela
A
Kinstler
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
William P
WP
Vidonish
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Michael
M
Wagner
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Li
L
Lin
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Kermit G
KG
Davis
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Susan E
SE
Kotowski
J'ai Watson is a graduate student, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati, and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Angela Kinstler is clinical director, cardiac intensive care unit, William P. Vidonish is a project manager, and Li Lin is a statistician, Center for Professional Excellence, Cincinnati Children's Hospital Medical Center. Michael Wagner is an associate professor, Department of Biomedical Informatics, Cincinnati Children's Hospital Research Foundation, Cincinnati, Ohio. Kermit G. Davis is an associate professor, Low Back Biomechanics and Workplace Stress Laboratory, Department of Environmental Health, University of Cincinnati. Susan E. Kotowski is an assistant professor, Department of Rehabilitation Sciences, College of Allied Health Sciences, University of Cincinnati. Nancy M. Daraiseh is an assistant professor, Research in Patient Services, James M. Anderson Center for Health Systems Excellence, Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center.
Nancy M
NM
Daraiseh
D003430:Cross-Sectional Studies; D006272:Health Facility Environment; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D015278:Intensive Care Units, Pediatric; D009622:Noise / Q000009:adverse effects*; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D010865:Pilot Projects; D013312:Stress, Physiological / Q000502:physiology*; D013315:Stress, Psychological / Q000209:etiology* / Q000503:physiopathology*; D017132:Workplace