Over the past 40 years, average noise levels in hospitals

have increased by a full 15 decibels, reaching levels of

around 70 decibels, well above the World Health
Organization’s recommended limit of 35 dB for a healing
environment.
Members of staff devote about 40 per cent of their work time to various forms of
communication. In order to make them more accessible, give them a better overview and bring
them closer to the patients, many hospital employees work in open-plan environments. This
might be in emergency or intensive care departments or nurses’ stations located in or at the
intersection of corridors.
Within this space, staff are expected to hear and interpret alarms, conduct confidential
conversations, carry out their rounds and, in many cases, undertake complex medical tasks. A
suboptimal acoustic environment increases the risk of miscommunication and hence errors, as
well as contributing to unnecessarily high stress levels that take their toll on the staff.
Loud equipment noises, alarm sounds and voices all disturb healing sleep and cause stress to
patients. Patients in emergency departments, intensive care units (ICU), and operating theatres,
and newborn babies in neonatal units, are especially sensitive to disturbing sounds. Average
noise levels of up to 70 dB have been recorded inside incubators in neonatal units. Premature
babies are at greatly increased risk of permanent hearing damage.

How to improve the sound environment in hospitals:

 Room design imitating nature

Our hearing has evolved so that it works best

outdoors in the natural world. The objective is therefore to try to imitate nature’s acoustic
environment inside hospitals. In the natural world we seldom find straight, parallel surfaces
that reflect sound waves back and forth across a space, producing disturbing responses.
Consider the fact that long corridors designed only with reflective surfaces will carry sound
over longer distances, increasing noise levels in general. Irregular spatial design is therefore
preferable where possible. Irregular or convex-shaped reception desks could be a solution, as
these distribute the sound waves in different directions.
Sound-absorbent cleanable wall panels may be used to absorb noise from the nurses’ station
and corridors, reducing the overall noise level within the space. Printed with appropriate
motifs, such as serene images of nature, these can also help promote a sense of calm and
security.

 Reduce equipment noise

High noise levels in the vicinity of patients are a constant problem in ICU. Identify any sources
of excess noise, such as food trolleys, automatic door openers, telephones, beds, alarms and
pagers. The stand holding all the intravenous equipment is often the source of various alarm
sounds.
Although it is essential that certain alarms are heard above the background noise, it is
nevertheless possible to set requirements regarding noise levels when purchasing equipment.
Could the alarm sound gradually increase in volume? Alarm systems that do not employ
audible signals are also available.

 Increase distance between patient and noise source

 Consider increasing the distance between noisy
pieces of equipment and the patient’s ears. Our hearing is never turned off, and our brains
constantly process sound signals. Tearing open a sterile package can create a noise measuring
70 dB, so avoid doing so near the patient’s head. Step away towards the foot of the bed if
possible.

 Screens between patients

Overhearing other patients’ conversations, the sound of snoring and patients being in pain are
examples of noise that can be discomfiting. This is one of the less pleasant memories many
people are left with after being in hospital. The use of suitable, movable sound-absorbent
screens between patients, perhaps with a glazed upper section, so that staff do not lose sight of
other patients, could help.

 Ceilings and wall absorbers that meet hygiene standards

Operating theatres can be a noisy environment,

especially during orthopaedic procedures when surgeons use drills and saws. Meanwhile, clear
communication is absolutely essential to a successful operation.
Operating theatres often have bare, easily washable floors, walls and ceilings made from hard
materials, which contribute to high noise levels and prolonged reverberation.
However washable, disinfectable sound-absorbent ceilings and wall absorbers are available
that often meet all necessary hygiene standards.
 
Photos: J-P Christianson, Anders Kämpe, Elin Ohlson, Cathy Yeulet, Patrik Leonardsson.

A Wall Street Journal report describes 13 ways hospitals are reducing noise:

 
 

1. Replacing overhead staff paging systems with wireless

headsets.
2. Reducing the frequency and intensity of medical alarms.
3. Installing ambient white-noise machines.
4. Using sound-absorbing ceiling tiles and carpets.
5. Dimming lights in the evening.
6. Designating sleep hours during which there are no routine checks of vital signs
unless necessary.
7. Asking staff to talk quietly.
8. Installing a noise monitor to identify when noise needs to be diminished.
9. Allowing patients to close their doors and post a "Do Not Disturb" sign.
10. Providing patients "Quiet Kits" with sleep masks, earplugs and crossword
puzzles.
11. Programming TVs with calming music and images.
12. Offering headsets for TVs and iPads.
13. Creating teams to develop strategies for reducing noise.