Data_Sheet_2_Characterization of sound pressure levels and sound sources in the intensive care unit: a 1 week observational study.zip

BackgroundExposure to elevated sound pressure levels within the intensive care unit is known to negatively affect patient and staff health. In the past, interventions to address this problem have been unsuccessful as there is no conclusive evidence on the severity of each sound source and their role on the overall sound pressure levels. Therefore, the goal of the study was to perform a continuous 1 week recording to characterize the sound pressure levels and identify negative sound sources in this setting.
MethodsIn this prospective, systematic, and quantitative observational study, the sound pressure levels and sound sources were continuously recorded in a mixed medical–surgical intensive care unit over 1 week. Measurements were conducted using four sound level meters and a human observer present in the room noting all sound sources arising from two beds.
ResultsThe mean 8 h sound pressure level was significantly higher during the day (52.01 ± 1.75 dBA) and evening (50.92 ± 1.66 dBA) shifts than during the night shift (47.57 ± 2.23; F(2, 19) = 11.80, p < 0.001). No significant difference was found in the maximum and minimum mean 8 h sound pressure levels between the work shifts. However, there was a significant difference between the two beds in the based on location during the day (F(3, 28) = 3.91, p = 0.0189) and evening (F(3, 24) = 5.66, p = 0.00445) shifts. Cleaning of the patient area, admission and discharge activities, and renal interventions (e.g., dialysis) contributed the most to the overall sound pressure levels, with staff talking occurring most frequently.
ConclusionOur study was able to identify that continuous maintenance of the patient area, patient admission and discharge, and renal interventions were responsible for the greatest contribution to the sound pressure levels. Moreover, while staff talking was not found to significantly contribute to the sound pressure levels, it was found to be the most frequently occurring activity which may indirectly influence patient wellbeing. Overall, identifying these sound sources can have a meaningful impact on patients and staff by identifying targets for future interventions, thus leading to a healthier environment.

背景：已知重症监护病房（Intensive Care Unit, ICU）内暴露于高声压级（sound pressure level）环境会对患者与医护人员的健康造成负面影响。既往针对该问题的干预措施均未取得理想效果，原因在于尚无确凿证据明确各类声源的严重程度及其对整体声压级的影响。因此本研究旨在开展为期1周的连续监测，以表征该场景下的声压级特征并识别有害声源。
方法：本项前瞻性、系统性、定量观察性研究，在一间混合内科-外科重症监护病房内开展，为期1周，连续记录声压级与声源。研究采用4台声级计（sound level meter），并安排人工观察员在病房内记录两张病床周边产生的所有声源。
结果：日间（52.01±1.75 dBA）与晚间（50.92±1.66 dBA）班次的平均8小时声压级显著高于夜班（47.57±2.23 dBA；F(2, 19) = 11.80, p < 0.001）。各班次间的平均8小时最高与最低声压级无显著差异。然而，日间（F(3, 28) = 3.91, p = 0.0189）与晚间（F(3, 24) = 5.66, p = 0.00445）班次中，两张病床基于位置的声压级存在显著差异。患者区域清洁、入院与出院操作、肾脏介入操作（如透析）对整体声压级的贡献度最高，而医护人员交谈则是发生频率最高的活动。
结论：本研究明确了患者区域清洁、患者入院与出院操作及肾脏介入操作是对声压级贡献度最高的声源。此外，尽管医护人员交谈未被发现对声压级存在显著贡献，但其发生频率最高，可能会间接影响患者的健康状况。总体而言，识别上述声源可为未来干预措施提供明确靶点，进而改善病房环境的健康性，最终惠及患者与医护人员。