LAUSR

Introduction/Hypothesis: The ICU is often a noisy place, which may lead to sleep deprivation and delirium in patients and may affect ICU staff concentration, performance and health. This study examined the noise level in a general adult to determine the magnitude of the problem and identify daily noise patterns. Methods: This observational study was performed in a 21-bed medical-surgical ICU of a 1000-bed tertiary-care center (King Abdulaziz Medical City Riyadh, Saudi Arabia). Sound meters (SOUNDEAR II®) set to detect noise above 45 dB, were installed in two areas outside patient rooms (Monitor 1 close to the main entrance door and Monitor 2 close to the main nurse station) and inside the rooms (Monitors 3 and 4) on a different day. Data were retrieved from the devices and analyzed. Results: Analysis of data showed that noise level exceeded 45 dB in 88.9% of the time for Monitor 1 and 14.2% for Monitor 2 (p<0.001). In Monitor 1, the maximum noise level was 60.4 dB (sound 45.1 to 50 dB in 67.4% of the time; 50.1 to 60 dB in 20.5% and > 60 dB in 0.01%). In Monitor 2, the maximum noise level was 63 dB (sound 45.1 to 50 dB in 11.2% of the time; 50.1 to 60 dB in 2.9%, > 60 dB in 0. 1%). In both meters, there were multiple sound spikes that probably corresponded to increased staff activities, such as nurse handover (0700 to 0730 and 1900 to 1930), physician rounds, family visits and other activities. Inside the patient rooms, Monitor 4 showed a maximum noise level of 63.0 dB (sound 45.1 to 50 dB in 0.2% of the time; 50.1 to 60 dB in 98.3% and > 60 dB in 1.5%). Monitor 5 showed a maximum noise level of 65.8 dB (sound 45.1 to 50 dB in 0% of the time; 50.1 to 60 dB in 96.0% and > 60 dB in 4.0%). There was no difference in the average noise level between the two rooms (53.9±2.4 and 53.8±2.5 dB; p=0.78) with no obvious noise spikes. Conclusions: The ICU environment was noisy inside and outside patient rooms well above the recommended 30 to 35 dB level. These data will be utilized to establish a quality improvement project for noise reduction in our ICU.