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BACKGROUND: Hospitalized patients frequently report poor sleep, partly due to the inpatient environment. In-hospital sound and light levels are not well described on non–intensive care unit (non-ICU) wards. Although non-ICU wards may have lower average and peak noise levels, sound level changes (SLCs), which are important in disrupting sleep, may still be a substantial problem.
OBJECTIVE: To compare ambient sound and light levels, including SLCs, in ICU and non-ICU environments.
DESIGN: Observational study.
SETTING: Tertiary-care hospital.
MEASUREMENTS: Sound measurements of 0.5 Hz were analyzed to provide average hourly sound levels, sound peaks, and SLCs greater than or equal to 17.5 decibels (dB). For light data, measurements taken at 2-minute intervals provided average and maximum light levels.
RESULTS: The ICU rooms were louder than non-ICU wards; hourly averages ranged from 56.1 plus or minus 1.3 dB to 60.3 plus or minus 1.7 dB in the ICU, 47.3 plus or minus 3.7 dB to 55.1 plus or minus 3.7 dB on the telemetry floor, and 44.6 plus or minus 2.1 dB to 53.7 plus or minus 3.6 dB on the general ward. However, SLCs greater than or equal to 17.5 dB were not statistically different (ICU, 203.9 plus or minus 28.8 times; non-ICU, 270.9 plus or minus 39.5; P = 0.11). In both ICU and non-ICU wards, average daytime light levels were less than 250 lux, and peak light levels occurred in the afternoon and early evening.
CONCLUSIONS: While quieter, non-ICU wards have as many SLCs as ICUs do, which has implications for quality improvement measurements. Efforts to further reduce average noise levels might be counterproductive. Light levels in the hospital (ICU and non-ICU) may not be optimal for maintenance of a normal circadian rhythm for most people.
Read the entire article in the Journal of Hospital Medicine.
Also in JHM this month
Associations of physician empathy with patient anxiety and ratings of communication in hospital admission encounters
AUTHORS: Rachel Weiss, MD, Eric Vittinghoff, PhD, MPH, Margaret C. Fang, MD, MPH, Jenica E. W. Cimino, Kristen Adams Chasteen, MD, Robert M. Arnold, MD, Andrew D. Auerbach, MD, Wendy G. Anderson, MD, MS
A concise tool for measuring care coordination from the provider’s perspective in the hospital setting
AUTHORS: Christine M. Weston, PhD, and Sehyo Yune, MD, Eric B. Bass, MD, MPH, Scott A. Berkowitz, MD, MBA, Daniel J. Brotman, MD, Amy Deutschendorf, MS, RN, ACNS-BC, Eric E. Howell, MD, Melissa B. Richardson, MBA Carol Sylvester, RN, MS, Albert W. Wu, MD, MPH
Post–intensive care unit psychiatric comorbidity and quality of life
AUTHORS: Sophia Wang, MD, and Chris Mosher, MD, Anthony J. Perkins, MS, Sujuan Gao, PhD, Sue Lasiter, RN, PhD, Sikandar Khan, MD, Malaz Boustani, MD, MPH, Babar Khan, MD, MS
An opportunity to improve Medicare’s planned readmissions measure
AUTHORS: Chad Ellimoottil, MD, MS, Roger K. Khouri Jr., MD, Apoorv Dhir, BA, Hechuan Hou, MS, David C. Miller, MD, MPH, James M. Dupree, MD, MPH
Against medical advice discharges
AUTHORS: David Alfandre, MD, MSPH, Jay Brenner, MD, Eberechukwu Onukwugha, MS, PhD
BACKGROUND: Hospitalized patients frequently report poor sleep, partly due to the inpatient environment. In-hospital sound and light levels are not well described on non–intensive care unit (non-ICU) wards. Although non-ICU wards may have lower average and peak noise levels, sound level changes (SLCs), which are important in disrupting sleep, may still be a substantial problem.
OBJECTIVE: To compare ambient sound and light levels, including SLCs, in ICU and non-ICU environments.
DESIGN: Observational study.
SETTING: Tertiary-care hospital.
MEASUREMENTS: Sound measurements of 0.5 Hz were analyzed to provide average hourly sound levels, sound peaks, and SLCs greater than or equal to 17.5 decibels (dB). For light data, measurements taken at 2-minute intervals provided average and maximum light levels.
RESULTS: The ICU rooms were louder than non-ICU wards; hourly averages ranged from 56.1 plus or minus 1.3 dB to 60.3 plus or minus 1.7 dB in the ICU, 47.3 plus or minus 3.7 dB to 55.1 plus or minus 3.7 dB on the telemetry floor, and 44.6 plus or minus 2.1 dB to 53.7 plus or minus 3.6 dB on the general ward. However, SLCs greater than or equal to 17.5 dB were not statistically different (ICU, 203.9 plus or minus 28.8 times; non-ICU, 270.9 plus or minus 39.5; P = 0.11). In both ICU and non-ICU wards, average daytime light levels were less than 250 lux, and peak light levels occurred in the afternoon and early evening.
CONCLUSIONS: While quieter, non-ICU wards have as many SLCs as ICUs do, which has implications for quality improvement measurements. Efforts to further reduce average noise levels might be counterproductive. Light levels in the hospital (ICU and non-ICU) may not be optimal for maintenance of a normal circadian rhythm for most people.
Read the entire article in the Journal of Hospital Medicine.
Also in JHM this month
Associations of physician empathy with patient anxiety and ratings of communication in hospital admission encounters
AUTHORS: Rachel Weiss, MD, Eric Vittinghoff, PhD, MPH, Margaret C. Fang, MD, MPH, Jenica E. W. Cimino, Kristen Adams Chasteen, MD, Robert M. Arnold, MD, Andrew D. Auerbach, MD, Wendy G. Anderson, MD, MS
A concise tool for measuring care coordination from the provider’s perspective in the hospital setting
AUTHORS: Christine M. Weston, PhD, and Sehyo Yune, MD, Eric B. Bass, MD, MPH, Scott A. Berkowitz, MD, MBA, Daniel J. Brotman, MD, Amy Deutschendorf, MS, RN, ACNS-BC, Eric E. Howell, MD, Melissa B. Richardson, MBA Carol Sylvester, RN, MS, Albert W. Wu, MD, MPH
Post–intensive care unit psychiatric comorbidity and quality of life
AUTHORS: Sophia Wang, MD, and Chris Mosher, MD, Anthony J. Perkins, MS, Sujuan Gao, PhD, Sue Lasiter, RN, PhD, Sikandar Khan, MD, Malaz Boustani, MD, MPH, Babar Khan, MD, MS
An opportunity to improve Medicare’s planned readmissions measure
AUTHORS: Chad Ellimoottil, MD, MS, Roger K. Khouri Jr., MD, Apoorv Dhir, BA, Hechuan Hou, MS, David C. Miller, MD, MPH, James M. Dupree, MD, MPH
Against medical advice discharges
AUTHORS: David Alfandre, MD, MSPH, Jay Brenner, MD, Eberechukwu Onukwugha, MS, PhD
BACKGROUND: Hospitalized patients frequently report poor sleep, partly due to the inpatient environment. In-hospital sound and light levels are not well described on non–intensive care unit (non-ICU) wards. Although non-ICU wards may have lower average and peak noise levels, sound level changes (SLCs), which are important in disrupting sleep, may still be a substantial problem.
OBJECTIVE: To compare ambient sound and light levels, including SLCs, in ICU and non-ICU environments.
DESIGN: Observational study.
SETTING: Tertiary-care hospital.
MEASUREMENTS: Sound measurements of 0.5 Hz were analyzed to provide average hourly sound levels, sound peaks, and SLCs greater than or equal to 17.5 decibels (dB). For light data, measurements taken at 2-minute intervals provided average and maximum light levels.
RESULTS: The ICU rooms were louder than non-ICU wards; hourly averages ranged from 56.1 plus or minus 1.3 dB to 60.3 plus or minus 1.7 dB in the ICU, 47.3 plus or minus 3.7 dB to 55.1 plus or minus 3.7 dB on the telemetry floor, and 44.6 plus or minus 2.1 dB to 53.7 plus or minus 3.6 dB on the general ward. However, SLCs greater than or equal to 17.5 dB were not statistically different (ICU, 203.9 plus or minus 28.8 times; non-ICU, 270.9 plus or minus 39.5; P = 0.11). In both ICU and non-ICU wards, average daytime light levels were less than 250 lux, and peak light levels occurred in the afternoon and early evening.
CONCLUSIONS: While quieter, non-ICU wards have as many SLCs as ICUs do, which has implications for quality improvement measurements. Efforts to further reduce average noise levels might be counterproductive. Light levels in the hospital (ICU and non-ICU) may not be optimal for maintenance of a normal circadian rhythm for most people.
Read the entire article in the Journal of Hospital Medicine.
Also in JHM this month
Associations of physician empathy with patient anxiety and ratings of communication in hospital admission encounters
AUTHORS: Rachel Weiss, MD, Eric Vittinghoff, PhD, MPH, Margaret C. Fang, MD, MPH, Jenica E. W. Cimino, Kristen Adams Chasteen, MD, Robert M. Arnold, MD, Andrew D. Auerbach, MD, Wendy G. Anderson, MD, MS
A concise tool for measuring care coordination from the provider’s perspective in the hospital setting
AUTHORS: Christine M. Weston, PhD, and Sehyo Yune, MD, Eric B. Bass, MD, MPH, Scott A. Berkowitz, MD, MBA, Daniel J. Brotman, MD, Amy Deutschendorf, MS, RN, ACNS-BC, Eric E. Howell, MD, Melissa B. Richardson, MBA Carol Sylvester, RN, MS, Albert W. Wu, MD, MPH
Post–intensive care unit psychiatric comorbidity and quality of life
AUTHORS: Sophia Wang, MD, and Chris Mosher, MD, Anthony J. Perkins, MS, Sujuan Gao, PhD, Sue Lasiter, RN, PhD, Sikandar Khan, MD, Malaz Boustani, MD, MPH, Babar Khan, MD, MS
An opportunity to improve Medicare’s planned readmissions measure
AUTHORS: Chad Ellimoottil, MD, MS, Roger K. Khouri Jr., MD, Apoorv Dhir, BA, Hechuan Hou, MS, David C. Miller, MD, MPH, James M. Dupree, MD, MPH
Against medical advice discharges
AUTHORS: David Alfandre, MD, MSPH, Jay Brenner, MD, Eberechukwu Onukwugha, MS, PhD