The impact of noise in the care environment

In the U.S., we often think of noise in the context of patient satisfaction and sleep, but noise (an inevitable characteristic of health care operations) has an impact on staff, too. Staff communications, equipment alarms and patients all contribute to an environment that can be disturbing and even distracting for caregivers. Three recent noise-related research studies highlight the global nature of the influence of noise on staff, physiologically and psychologically.

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Bayramzadeh and Ahmadpour considered noise as part of a study on sensory stimulation in emergency department (ED) trauma rooms in the U.S. Observations by focus group participants specific to noise included the distracting nature of high noise levels that impair communication, contribute to alarm fatigue, create staff frustration and even delay care. 

Top sources of noise included environmental factors related to doors, layout design, materials and finishes, and multi-occupancy rooms; patients; staff communication; and equipment alarms.

Equipment alarms that could not be silenced for more than a few seconds were a particular annoyance because patients in ED trauma rooms were often surrounded by caregivers actively addressing the life-threatening issues initiating the alarms. Additionally, because trauma events are often attended by learners whose conversation adds to ED noise levels, one staff recommendation proposed was an alcove with a glass window that would permit observation yet mitigate noise and disruption.

Abbasi and colleagues sought to better understand hospital employee exposure to noise pollution and looked at relationships among noise annoyance, general health and aggression in staff at two different hospitals in Iran. The team surveyed 113 staff members and measured noise levels at 113 different stations across two sites. The highest noise levels were found in the ED, laboratory and pediatric units, with the critical care unit measuring the lowest noise level.

Although the researchers did not find significant differences across shifts, they did note that staff members who were exposed to higher noise levels at their workstations reported higher levels of noise annoyance, while noise sensitivity was correlated to general health issues and aggression.

Das and Kishore surveyed 450 staff members at a 1,600-bed hospital in India and collected noise data from seven outdoor and 23 indoor locations. The highest noise levels were found in the outpatient registration department, and as in the Abbasi study, noise levels were higher at nursing stations compared to other unit locations. 

The researchers found that about 75% of those surveyed were annoyed by hospital noise, with the most common sources of such noise to be patient and visitor conversations, mobile phones, patient movement and staff conversations. Das and Kishore also noted that noise levels and staff member annoyance were higher during the day and on weekdays than on weekends.

Although noise levels may be influenced by models of care and patient loads that differ in each country, noise is a recognized health problem worldwide. As we consider the ways to better care for staff members, we should keep in mind how we manage noise-induced annoyance.

If you are interested in more research on noise in health care settings, you can find articles on this and other health care design topics in The Center for Health Design’s Knowledge Repository.

Research used for this column

The following research citations from The Center for Health Design’s Knowledge Repository of health care design resources were used by the author when writing this column:

• S. Bayramzadeh and S. Ahmadpour, “The Impact of Sensory Stimuli on Healthcare Workers and Outcomes in Trauma Rooms: A Focus Group Study,” HERD: Health Environments Research & Design Journal, 2023, in press.
• H. Abbasi et al., “Noise Pollution, Annoyance, and Sensitivity; Its Impact on General Health and Aggression of Hospital Staffs,” Current Psychology, 2023, in press.
• A. Das and J. Kishore, “Noise Levels and Annoyance among Staff in a Tertiary Care Hospital in North India: A Cross-Sectional Study,” Archives of Environmental & Occupational Health, 2023, 1–12.

About this column

“Design Discoveries” highlights research from The Center for Health Design’s Knowledge Repository, a user-friendly library of health care design resources. This research effort is supported by the American Society for Health Care Engineering, the American Institute of Architects, the Academy of Architecture for Health Foundation and the Facility Guidelines Institute.

Yolanda Keys, R.N., NEA-BC, EDAC, research associate, The Center for Health Design.