SOUND IN HEALTHCARE ENVIRONMENTS
Making room acoustics a resounding success
Research shows that the sound and acoustics generated in healthcare settings have a major impact on both patients and nursing staff. Hospitals are now noisy places, and do not always provide an acoustic environment designed for healing. Sound levels are still increasing, but are we listening? Andrea Harman, Concept developer, Healthcare, Saint-Gobain Ecophon, discusses some of the main considerations in creating a quieter, more calming, recovery environment.
Poor room acoustic environments make us anxious, stressed, tired, and error-prone; thus when we imagine a space designed for rest and recovery, we think of a place that is quiet, peaceful, and calm – for both patients, and the people working there. In reality a hospital is very different to that image. Patients are often surrounded by noise from alarms, equipment, and voices, and since the 1970s sound levels have been increasing. While the World Health Organization (WHO) suggests that average hospital sound levels should not exceed 35 dB, many studies have shown levels that are consistently far higher than this. A UK-based study on a stroke
rehabilitation ward registered average daytime levels of 64 dB, and night-time levels of 56 dB, with repeated single sounds of 100 dB. Sound is expressed using a logarithmic scale, so the actual increase is far more impactful than the figures may suggest. 64 dB is the equivalent sound level to that of people laughing, while 100 dB is equivalent to someone close by using a jackhammer.
Acoustic drawbacks of multi-bed wards The design of spaces, and the materials used, will also affect sound levels, and how sound moves within the space. The open design and multi-bed wards of many hospital environments make them more accessible, and give staff a better overview, bringing them closer to patients. However, this often allows sound to travel long distances without interruption. The hard finishes designed for ease of cleaning and longevity reflect sound back into a space, so that it builds interference with communication, while also disturbing healing sleep, and increasing stress and anxiety. High noise levels from speaking and monitors and alarms close to patients are a constant problem, and our hearing is never turned off, with our brains constantly trying to process sound signals even when we are very ill or apparently unresponsive. Patients in Emergency Departments and intensive care units, and newborn babies in neonatal units, are especially sensitive to disturbing sounds.
Printed sound-absorbent wall panels and ceilings create interest in paediatric consulting rooms.
Sleep disruption We all know that it is often noise that prevents us going to sleep, especially when we are somewhere different, and that it is likely to be noise that wakes us up during the night. We also know how tired, sluggish, and stressed, we can then feel after a poor night’s sleep. For patients in hospital this stress has been negatively linked to delirium, pain perception, and wound healing. Within intensive care patients can find some sound positive and reassuring, e.g. that of staff quietly checking on their wellbeing. However, hearing conversations between staff perceived to be about them or other patients, hearing other patients, but not being able to see them, and noisy monitors, can all have a negative impact. Average noise levels of up to 70 dB have been recorded inside incubators in neonatal units, with the noise of a porthole closing registered at 100 dB. High noise
A ‘traffic light’-style noise warning sign.
levels have been linked to an increased risk of premature babies developing permanent hearing damage. There are also many examples of how
the acoustic environment can positively affect patient outcomes. As noise at night stops us sleeping, it is an easy step to link a reduction in noise on a hospital ward to an improvement in sleep quality, and for this improved sleep to affect a patient’s mood, feelings, and outcomes.
Swedish research study In a research study at Huddinge University Hospital in Sweden, in an intensive coronary care unit, the room’s acoustic conditions were changed from sound- reflective to sound-absorbent by installing a Class ‘A’ sound-absorbent suspended ceiling. This absorbed between 85 and 100% of the sound that reached it. Measurements and evaluations were taken both pre- and post- the ceiling change. The patients recovering with good room acoustic conditions required less pain medication, had a shorter hospital stay, and were far less likely to be readmitted
January 2023 Health Estate Journal 69
Photo courtesy of NoiseMeters Ltd
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