April 1, 2014

Noise Free America
For immediate release

Ted Rueter
[email protected]

Chapel Hill: The American hospital industry has won this month’s Noisy Dozen award from Noise Free America for tolerating and promoting a culture of noise within facilities which are supposed to promote health and healing.

There are numerous sources of unnecessary noise in American hospitals: announcements blaring from overhead speakers, rumbling heating and cooling systems, loud television sets, employees and visitors speaking loudly, banging doors, and squeaky-wheeled gurneys.

Perhaps the worst source of unnecessary hospital noise is constant beeping from electronic devices. The Boston Medical Center found that just one of its floors had 12,000 alarms a day, on average. This cacophony of constant beeping produces “alarm fatigue.” A 2011 investigation by The Boston Globe found “more than 200 deathsnationally related to alarm problems.”

Holly Barnes experienced this problem firsthand: “The constant beeping is also hard on the patient. When I was in the labor and delivery ICU, I had so many things attached to me, most of them noisy. I couldn’t get up from the bed, so my ‘job’ was to rest, but that’s near impossible with all the beeping going on. Some nurses would agree to silence some of the machines, but others would not. And when I was in for a severe kidney infection, the IV machine was terrible. I had a migraine and was super sensitive to sound, and these machines were brand new and overly sensitive (according to the docs and nurses). One slight touch or movement, and its alarms would go off. I cursed at the machine over and over again and nearly threw it across the room at one point. Soooo frustrating.”

Douglas P. posted this comment on the same NPR message board: “This very situation made me quite angry about nine months ago when my Mom had a stroke. They had her hooked up to a ventilator that beeped loudly every time she didn’t breathe in a nice regular pattern. No nurse came in to check on her, and understandably so. It was utterly pointless. Then her IV bag would go off when it was empty. I can see situations where you’d need to know that, but in her case it just signified that round of medication was over. It was loud and annoying, but the nurses ignored it until their regular check-in time. And then she had a feeding tube up her nose that had a pump. The tube tended to clog regularly and a loud alarm would go off. Nobody paid any attention to it because it wasn’t an emergency.”

While being exposed to the hospital noise, Douglas had this thought: “This is as stupid as backup alarms on forklifts. I work in a shop with a lot of people and several forklifts that run all the time. Every time they go in reverse there’s a backup alarm. That means there’s a backup alarm going about half the time. Everyone is so desensitized to them they ignore them.”

Researchers at Johns Hopkins University found that “hospital noise levels internationally have grown steadily over the past five decades, disturbing patients and staff members” and “raising the risk of medical errors…Some studies even indicate that excessive noise can slow the pace of healing and contribute to stress and burnout among hospital workers.”

The Johns Hopkins researchers found that “Since 1960, average daytime hospital sound levels around the world have risen from 57 decibels to 72; nighttime decibel levels have jumped from 42 decibels to 60. All of these figures exceed the World Health Organization’s 1995 hospital noise guidelines, which suggest that sound levels in patient rooms should not exceed 35 decibels. The measurements vary little among different types of hospitals, indicating the problem is pervasive.”

All of this noise is very damaging to patients. The Boston Globe reports that “a growing body of research suggests that the noise itself actually harms patients, interfering with the healing process, increasing the likelihood of medical errors, and raising the stress level of everyone on the premises. Studies have shown that patients sleep poorly and take longer to recover from surgery in noisier hospitals and that loud neonatal wards may delay development in premature babies. Wounded rats heal more slowly in noisy environments; heart patients in loud wards are more likely to be re-hospitalized later. By interrupting sleep and increasing stress, noise batters the body.”

In her 1959 classic, “Notes on Nursing,” Florence Nightingale described unnecessary noise as “the most cruel absence of care which can be inflicted either on sick or well.”

Fortunately, a few American hospitals are taking action to reduce unnecessary noise. The Boston Medical Center eliminated numerous “warning” alarms, reducing the number of alarms on one floor from 90,000 a week to 10,000 a week. Similarly, Cambridge Hospital installed sound-monitoring devices (called a “Yacker Tracker“) at nursing stations to encourage hospital staff members assembled there to be aware of their sound levels. Massachusetts General Hospital “began a noise-reduction program in 2008, with quiet rubber wheels for hallway carts, new limits on overhead paging, and headphones for patients instead of blaring TVs.” Mass General has also instituted a daily “quiet time“–an hour during which “the lights are dimmed, bedroom doors closed, and patients are given60 minutes without a doctor or nurse coming by to ask them something or check in.”

Ted Rueter, Noise Free America’s director, commented that “hospital noise is truly out of control. It is a testament to American society’s lack of understanding of the harms of noise. Excessive noise is associated with heart disease, sleep deprivation, hearing loss, ringing of the ears, chronic fatigue, and aggravated behavior. The fact that most hospital administrators, doctors, and nurses do not understand the harms of noise shows just how far we are from achieving peace and quiet.”

Noise Free America is a national citizens’ organization opposed to noise pollution. Past “winners” of the Noisy Dozen award include the National Football League, the DC Metro system, and the Federal Aviation Administration.