By Julie Deardorff, Tribune Reporter
The busy eighth floor of Chicago's St. Joseph Hospital is buzzing with noise. Alarms beep incessantly. The elevator dings each time the doors open. During the shift change, the "cocktail party effect" kicks in; people talk louder, straining to be heard over the hubbub. "When I get home at midnight, I can still hear it in my head," nurse Pedro Arreza said, pointing to the electronic monitors.
Portland (Multnomah, Oregon) Health care is noisier than ever. Worldwide, the sound levels inside hospitals average 72 decibels (dB) during the day and 60 dB at night, far exceeding the standard of 40 dB or less, set by the World Health Organization. The racket is generated by obvious bedfellows: human beings and technology. But the clam-our of modern medicine can harm both patients and staff, a growing body of research on noise and health suggests. Unwanted sound wrecks sleep, raises stress levels, induces medical mistakes and contributes to alarm fatigue, which occurs when monitors shriek so often they are ignored or turned off, causing safety issues.
In response to concerns, hospitals throughout Illinois and the U.S. are launching "quiet campaigns" that include eliminating intercom paging, replacing metal trash cans, install-ing sound-absorbing flooring and panelling, and dimming lights at night to remind staff to keep their voices down. Northwestern's Prentice Women's Hospital was designed with multiple smaller nurses stations rather than one central one to reduce noise. In the neonatal intensive care unit at the University of Chicago, signs designed to protect babies' underdeveloped nervous systems say: "Did you know? Tapping on the top of an isolette (incubator) is equivalent to the sounds of heavy traffic during rush hour!"
Helping health officials rethink hospital safety and design is the Healthcare Acoustics Research Team (HART), an unusual collaboration of experts with experience in acoustics, engineering, architecture, psychology and medicine. Ilene Busch-Vishniac is a HART team member and co-author of an important Johns Hopkins study that showed day and night-time sound levels have risen significantly in hospitals since 1960.
Hospitals also are highly reverberant spaces "that contain the full spectrum of humanity, usually at their most vulnerable," said Diana Pope, a nursing research scientist for the Department of Veterans Affairs at the Portland Medical Center in Oregon and another HART researcher.
The buildings feature hard, easy-to-clean surfaces such as tile floors. Porous or fuzzy materials are rarely used to absorb energy or deaden sound in health care settings because they can harbor microorganisms.
Today, noise, even more than hospital food, is one of the top hospital complaints. Patients exposed to the loudest sounds can lose up to two hours of sleep each night, ac-cording to University of Chicago researchers who studied how noise affects the elderly. Sleep deprivation can trigger health problems, including high blood pressure and high blood sugar, fatigue and mood changes. Studies also re-port that noise in hospitals increases respiratory rates and cortisol levels. People in noisy recovery rooms requested more pain medication. Preterm infants, perhaps the most sensitive population, are at increased risk for hearing loss, abnormal brain and sensory development, and speech and language problems when exposed to prolonged and excessive noise.
Nevertheless, hospitals are doing what they can to turn down the sound. Rush University Medical Center’s new hospital is trying to reduce noise by 90 percent from its current operation, said Mick Zdeblick, Rush's vice president of campus transformation. The new patient care hall-ways will be carpeted. In off hours, lights will be dimmed to encourage softer voices in the hallway. The building's ventilation system has been designed to be quieter. Hanging more sound-absorbing artwork in the hallways, such as a canvas without glass, or decorative cloth reliefs is considered.
Many hospitals have installed Yacker Trackers, a kitschy sound meter that looks like a stoplight and flashes red when it gets too noisy. Marketed for school classrooms, the Yacker Tracker is hardly a scientific instrument. And though it had been in use at St. Joseph for less than two weeks, its novelty and effectiveness seem to have worn off. Between 2 and 3:30 p.m. on a Tuesday, the device hit red 301 times. Each time, much to the staff's annoyance, a low-pitched siren went off, adding to the din.
Still, Arreza said it was a good reminder that patients need rest. And every so often, he lightens the mood by walking up to the Yacker Tracker and laughing at it, just to see what will happen. In her 1859 book "Notes on Nursing," Florence Nightingale railed against unnecessary noise, calling it "the most cruel absence of care."
Excerpted from the Chicago Tribune newspaper