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Nurses chat in a busy hallway at Virginia Mason Medical Center. The Seattle hospital tops the list of the state's noisiest hospitals (pdf). Photo by John Ryan.

Nurses chat in a busy hallway at Virginia Mason Medical Center. The Seattle hospital tops the list of the state's noisiest hospitals (pdf). Photo by John Ryan.

KUOW News

Hospital Patients Feel The Noise

John Ryan
11/14/2011

Hospitals have long fought disease, and many of them are now fighting noise as well. Noise is a top patient complaint, and studies show noise can keep patients from returning to health. KUOW's John Ryan has more.

TRANSCRIPT

Hospitals are places of healing. But that doesn't mean they're restful places.

Step inside almost any hospital, and you'll hear all kinds of racket.

Heavy doors opening and closing. Carts wheeling down the halls. Nurses and patients talking. And all sorts of medical gadgets and alarms beeping and buzzing and blaring.

It can all add up to a surround–sound experience where people least want one.

For the past several years, American hospitals have been required to survey their patients. The hospitals have to report on 10 different measures of patient satisfaction.

Across the nation, patients complain about noise more than anything else. And according to those patient surveys, hospitals in Washington state are noisier than the national average.

Andrea Yount: "I think the noise disturbed my sleep most of anything, and when you're sick, sleeping is kind of the way you heal yourself."

Andrea Yount spent three nights at Seattle's Swedish Hospital while she recovered from a hysterectomy. She had a private corner room, but she says nurses and others talking in the hall kept her from sleeping more than 20 minutes at a stretch.

Yount: "Ultimately, it made my stay a lot more tiring. I mean, you're going to come home tired from an operation, but I was exhausted. I think I slept for a week afterwards, and I was up and walking after my surgery in probably two or three hours."

Officials at Swedish and other hospitals say they've taken lots of measures to pipe down.

Annette Stier: "Let's walk down this way."

Staff at Olympia's Providence St. Peter Hospital have been trying to hush up for the past couple years.

Stier: "My name's Annette Stier, and I'm the director of women's and children's here at Providence St. Peter."

Her section of the hospital has noise detectors that light up when things get too loud. She claps to trigger one of them.

Stier: "When the quiet light comes on, it tells me we need to slow our voices down, and we need to be quieter."

John Ryan: "Why is quiet especially important here?"

Stier: "Well, we have small babies, and some of them are preemie babies, and startling noises will make them jerk and make them become so startled that they may hold their breath. And so then they use up their stores of their glucose, which then may make them have to have an IV which they didn't have to. So they are far more sensitive."

In many wards, St. Pete has has installed sound–absorbing surfaces. The hospital has reduced the number of overhead pages and instituted afternoon quiet hours. Other hospitals report similar efforts.

Still, hospitals have found that quiet can be as elusive as a perfect bill of health.

Since the patient surveys began, Virginia Mason Medical Center in Seattle has received worse scores on nighttime noise than any other hospital in Washington.

Janet Goulding Streifel: "It is an ongoing concern that we be able to provide a quiet therapeutric environment for patients."

Janet Goulding Streifel runs the orthopedics unit at Virginia Mason.

Older parts of Virginia Mason have busy, narrow hallways with patient rooms crowded together. Nurses gather at centralized work stations. Their conversations ricochet into patients' rooms.

Goulding Streifel: "When multiple conversations are going on, people are going to talk louder to overcome that background noise, and that's where you just generate huge amounts of noise."

Carts carrying computers, linens and food get wheeled from room to room.

Goulding Streifel: "Transporting equipment right outside the patient rooms does create noise. The squeaky wheel, the rattling; those types of noises are not ideal."

Virginia Mason has been replacing its squeakiest wheels and rescheduling deliveries to allow patients an afternoon quiet hour.

Goulding Streifel: "So for the whole hour, you wouldn't have the big cart of linen rattling down the hall."

The hospital also instructs nurses to pipe down when there are patients nearby. But there's only so much you can do in an old space.

Virginia Mason's brand new orthopedics unit has rubberized floors and no more traditional nurses stations. Nurses work alone or in pairs at much smaller, less chatty work stations.

Concern with noise is nothing new in health care.

Way back in 1859, British Nurse Florence Nightingale railed against noise.

Nightingale [actor]: "Unnecessary noise is the most cruel absence of care which can be inflicted either on sick or well."

But as machines and electronic gadgets have proliferated in health care, hospitals have gotten noisier, not quieter.

And sometimes, that electronic noise isn't just aggravating to patients. It's potentially dangerous.

Paul Schyve: "There's more machines with more alarms, and essentially they become confusing and overwhelming to the people that are working in that setting."

Paul Schyve is a psychiatrist with an organization called the Joint Commission. It certifies quality and safety at hospitals nationwide.

Schyve: "So there may be, literally, in some settings, an alarm going off all the time, and frequently more than one alarm."

Each manufacturer puts a different set of bells and whistles on its medical devices, each one designed to be more alarming than the competitor's. Pretty soon —

Schyve: "Essentially, your brain habituates to background noise that's always there. So if there's alarms going off all the time, sooner or later that alarm actually registers less in your brain than it did originally."

It's a phenomenon known as "alarm fatigue."

Nationwide, the Food and Drug Administration has reported about 140 deaths a year related to patient alarms. In many cases, medical staff ignored or failed to notice a key alarm.

The Joint Commission will make alarm fatigue one of its top priorities for improving hospital care in the coming year.

Paul Schyve says alarms on medical devices are a vital part of health care, but he says it will take cooperation of hospitals and equipment manufacturers to help essential alarms rise above the noise.

I'm John Ryan, KUOW News.

© Copyright 2011, KUOW

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