Scenario
You are a student nurse at Rush Hospital and were recently chosen to be the student representative of the newly formed Holistic Nursing Committee. Hospital leadership has asked your committee to address inpatient complaints about the amount of general noise pollution throughout the hospital.
The committee members feel this is a perfect opportunity to demonstrate how the holistic caring process can be applied to addressing the problem of noise pollution in the hospital. They have asked you to write an executive summary for hospital leadership.
You have a basic familiarity with holistic interventions that enhance the inpatient experience and promote healing, but know you will need to investigate evidence-based research about noise reduction and optimization.
Instructions
Write an executive summary that demonstrates the use of the holistic caring process to address general noise pollution in the hospital. The summary should be approximately 3-5 pages in length and include:
1. A summary of the holistic intervention you recommend be implemented in the hospital to combat general noise pollution. It should address the following:
2. Briefly describe the intervention. Be sure to support your recommendation using at least three evidence-based research articles.
3. Provide a statement of how this intervention could be incorporated into a patient’s therapeutic care plan.
4. Describe how this intervention would reduce general noise pollution in the hospital.
5. Describe how you would evaluate this intervention over time.
6. Assessment of the problem, challenges, and outcomes associated with hospital noise pollution. Include the following:
7. A description of general noise pollution in the hospital setting.
8. At least two sources of noise pollution in the hospital setting.
9. At least two health effects of noise pollution on patients.
10. At least two health effects of noise pollution on staff.
11. Discussion of the evidence-based, holistic caring interventions for addressing noise pollution in the hospital setting. Include the following:
12. At least one recommendation for acceptable sound levels in the hospital.
13. At least one evidence-based, holistic, mind-body intervention that promotes health and well-being in the hospitalized patient.
14. At least one evidence-based, holistic, environmental intervention for addressing noise pollution.
Assessment of the Problem: Hospital Noise Pollution
Description and Sources of General Noise Pollution
General noise pollution in the hospital setting is defined as unwanted or excessive sound that can interfere with communication, cause stress, and disrupt sleep and rest. It is a critical, often-overlooked environmental stressor. Noise levels in hospitals frequently exceed acceptable standards, sometimes reaching levels comparable to heavy traffic or a lawnmower, even in quiet hours.
At least two primary sources of noise pollution include:
Staff and Operational Noise: This includes conversations among staff, overhead paging, beeping alarms from medical equipment (which often leads to "alarm fatigue"), equipment movement (e.g., supply carts, beds), and doors opening/closing.
Patient and Visitor Noise: This encompasses patient calls, visitors' conversations, the sound of televisions, and general movement within the patient care areas and hallways.
Health Effects of Noise Pollution
The constant exposure to high levels of unpredictable noise has profound negative effects on the physical, psychological, and spiritual health of all individuals in the hospital environment.
At least two health effects on patients:
Sleep Disturbance and Fragmentation: Noise disrupts Rapid Eye Movement (REM) and non-REM sleep cycles, leading to sleep deprivation, which impairs immune function, delays wound healing, and is associated with increased incidence of delirium and cognitive impairment.
Physiological Stress Response: Noise triggers the body's fight-or-flight response, leading to a cascade of physiological changes including increased heart rate, elevated blood pressure, and higher levels of stress hormones (cortisol), ultimately consuming energy that would otherwise be dedicated to healing.
At least two health effects on staff:
Increased Stress, Fatigue, and Burnout: Continual noise exposure leads to physical and mental exhaustion, stress, irritability, and decreased attention span, contributing to high rates of nurse burnout.
Compromised Communication and Errors: The "cocktail party effect" causes staff to raise their voices to be heard, increasing overall unit noise. More critically, high background noise can impair clear communication between providers and patients, leading to mishearing critical instructions and increasing the risk of medical errors.
2. Discussion of Evidence-Based Holistic Interventions
Acceptable Sound Levels
Based on recommendations from the World Health Organization (WHO), the goal for acceptable average sound levels in patient treatment and observation areas should be:
Daytime (7:00 AM to 10:00 PM): An equivalent continuous sound level ($L_{Aeq}$) not to exceed 35 dBA.
Nighttime (10:00 PM to 7:00 AM): An equivalent continuous sound level ($L_{Aeq}$) not to exceed 30 dBA.
Holistic Mind-Body Intervention
Music Therapy:
Music therapy, or the use of selected music played via personal headphones or in common areas, is an evidence-based, holistic, mind-body intervention. It promotes health and well-being by reducing anxiety and pain perception, regulating vital signs, and offering a positive, controllable auditory stimulus to counteract disruptive noise. It engages the patient's consciousness and physiology to foster relaxation and comfort.
Holistic Environmental Intervention
Acoustical and Behavioral Modifications (Quiet Time):
A robust program of environmental modification—including designated Quiet Times and physical changes—is an evidence-based, holistic, environmental intervention for addressing noise pollution. This involves installing sound-absorbing materials (e.g., ceiling tiles, wall panels) and implementing mandatory quiet hours where all non-essential activity is minimized. This change in the physical and cultural environment is essential to meet the recommended decibel standards.