LAUSR

Learning Objectives: Though intended to heal, Intensive Care Unit (ICU) environments are often a source of stress for patients, families, and staff. Day/night cycle loss and continuous noise disrupt patient sleep and may exacerbate delirium. ICU sound levels frequently exceed World Health Organization (WHO) recommendations, and there are no similar standards for hospital light levels. Little pediatric ICU (PICU) specific data exists. We sought to determine the feasibility of simultaneous, continuously monitored light and sound in multiple PICU patient rooms. We hypothesized that there is minimal day/night light variability, and that the PICU does not meet sound level recommendations. Methods: Using Reed Instruments light (SD-1128) and sound meters (SD-4023), light and sound measurements (in lux every 30 sec and decibels (dB) every 2 sec, respectively) were continuously recorded in three patient rooms for 24 hours. The day was divided into two periods, from 0600-2059 and 2100-0559. Meters were wall-mounted behind the head of the bed to simulate patient experience and avoid impacting care. Results: Two of three pilot study rooms were occupied; one patient was mechanically ventilated, and one patient was not. Empty room lighting remained off. Occupied room lighting was dictated by patient care needs. All rooms have windows and demonstrated day/night light variability, even when unoccupied. All rooms were <15lux in the overnight period. However, average light levels during the day varied between rooms; average light intensity peaked at 38lux in one occupied room, compared with average peaks consistently >120lux in the other. Sound levels were consistently >45dB in all rooms. In the ventilated patient room the average was >50dB. In the non-ventilated patient room, the average was <50dB for a total of 1.5 hours overnight only; this time was not consecutive. Conclusions: This pilot study demonstrates feasibility of continuous light and sound measurement in the PICU. Similar to prior studies, our PICU sound levels are consistently above WHO-recommended 35dB. We are the first to report continuous PICU light data. Daytime light varied between rooms, though all rooms were darker than the 250-500lux suggested for locations such as classrooms and offices. Future studies will use continuous light and sound monitoring to simultaneously characterize all patient rooms in the PICU, and correlate environmental characteristics with severity of illness, pediatric delirium and variables such as sedative administration.