scholarly journals The impact of a noise reduction quality improvement project upon sound levels in the open-unit-design neonatal intensive care unit

2009 ◽  
Vol 30 (7) ◽  
pp. 489-496 ◽  
Author(s):  
W F Liu
2012 ◽  
Vol 5 (4) ◽  
pp. 76-87 ◽  
Author(s):  
Amber W. Trickey ◽  
Cody C. Arnold ◽  
Ankit Parmar ◽  
Robert E. Lasky

Objective: Sound levels, staff perceptions, and patient outcomes were evaluated during a year-long hospital renovation project on the floor above a neonatal intensive care unit (NICU). Background: Construction noise may be detrimental to NICU patients and healthcare professionals. There are no comprehensive studies evaluating the impact of hospital construction on sound levels, staff, and patients. Methods: Prospective observational study comparing sound measures and patient outcomes before, during, and after construction. Staff were surveyed about the construction noise, and hospital employee satisfaction scores are reported. Results: Equivalent sound levels were not significantly higher during construction. Most staff members (89%) perceived the renovation period as louder, and 83% reported interruptions of their work. Patient outcomes were the same or more positive during construction. Very low birth weight (VLBW infants were less likely to require 24+ hours' mechanical ventilation during construction: 54% vs. 59% before ( OR = 1.6, p = 0.018) and 62% after ( OR = 1.48, p = 0.065); and they required a shorter total period of mechanical ventilation: 3.6 days vs. 8.0 before ( p = 0.011) and 9.5 after ( p = 0.001). VLBW newborns' differences in ventilation days were mostly in the upper extremes; medians were similar in all periods: 0.6 days vs. 1 day preconstruction and 2 days postconstruction. Conclusions: Construction above the NICU did not cause substantially louder sound levels, but staff perceived important changes in noise and work routines. No evidence suggested that patients were negatively affected by the renovation period. Meticulous construction planning remains necessary to avoid interference with patient care and caregiver work environments.


2017 ◽  
Vol 22 (3) ◽  
pp. 115-123 ◽  
Author(s):  
Janet Delong Pettit ◽  
Elizabeth Li Sharpe

Abstract Background: Neonates are at greater risk for central-line-associated bloodstream infection due to prolonged vascular access for nutrition and medications. Skin antisepsis using chlorhexidine gluconate (CHG), particularly the formulation with alcohol (CHG/alcohol), during central line insertion and maintenance activities is a key clinical care process associated with central line-associated bloodstream infection reduction. One area of ongoing confusion for many clinicians is whether to adhere to the manufacturer's recommendations that CHG remain on the skin following the procedure to promote persistent microbicidal effects, or to foster product removal in hopes of preventing skin-related complications. Purpose: Determine the effect of a targeted education program on the knowledge and attitudes of nurses who place peripherally inserted central catheters in the neonatal intensive care unit regarding the use and removal of CHG antiseptic. Methods: A quasiexperimental presurvey/postsurvey quality improvement project recruited participants from the electronic mailing list of a national neonatal nursing organization. Results: There was a statistically significant deficiency in knowledge or misinformation related to the use of CHG/alcohol on the presurvey assessment. Eight questions reflecting knowledge consistent with most recent evidence were answered correctly only 11.4%–25.7% of the time, all of which were considered statistically significant. Following completion of the education program, a nearly 100% correct response rate on all but 3 postsurvey questions resulted. Conclusions: This quality improvement project demonstrated success in the ability to change knowledge surrounding the removal of CHG/alcohol from the skin of babies in a neonatal intensive care unit following completion of a targeted education program, and the effectiveness of targeted web-based educational programs.


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