"Adequate sleep is important to the healing process, and sleeping in the hospital is notoriously difficult," says Cheryl Cmiel, the lead author of the paper. "Our continuous improvement team wanted to find specific causes for the problem, and see what concrete steps we could take to help solve it."
In response to patient reports of poor sleep and noise while trying to sleep, the nursing team started its study by placing noise dosimeters in three empty patient rooms during a night shift, without the night staff's knowledge, to continuously measure decibel levels from 10 p.m. to 7 a.m. A second set of readings was taken when two nurses volunteered to sleep overnight in a semiprivate room, with equipment and monitors typically used during a thoracic surgery patient"s stay. They logged their experiences, noting bothersome noises that were then matched against the decibel readings. Patients in the thoracic surgery unit typically have had operations involving the lungs or esophagus, and the average length of their hospital stay is five to 10 days.
"We wanted to experience the patient's perspective, so we became patients for one night," says Cmiel. "We got an earful."
Peak dosimeter readings as high as 113 decibels - roughly equivalent to the noise of a chainsaw or a jackhammer - came at the time of morning shift change, around 7 a.m., although the 11 p.m. shift change also was noisy. Sleep-promoting changes made after the problems were identified included: