Sound stages

HD, Jan 2003 by Mazer, Susan E

Instead of setting up opaque sound baffles, use transparent barriers for waiting areas and other large rooms where conflicting activities take place. In a waiting area, if the objective is to provide television access for some visitors, then offer a quieter space for others.

Make recommendations for ways to enhance or condition the sound environment. Environments that are too noisy have inherent risks while those that are too quiet carry other risks. Therefore, the ideal sound environment is one intentionally designed to reduce avoidable noise, minimise noise that is unavoidable, and provide positive auditory input in order to mask distractions in an otherwise quiet space.

Readers may be familiar with 'pink noise: a frequency-specific sound that is introduced into an environment to render private conversations inaudible. Although it has been shown to be effective in workplaces, it is not appropriate for hospitals as it makes it difficult to locate patient alarms and is itself a distraction.

Enhancing the sound environment with music is a viable option if the music is carefully selected and used appropriately. In hospital settings, music therapy studies have been shown to reduce the amount of requested pain medication and/or improve its analgesic effect. When used appropriately, music acts as an effective audio-anxiolytic, improving restfulness and the quality of sleep, and inducing relaxation.

There are several music programming alternatives for patient television on the market that cost pence per bed, per day. Important considerations for this type of programming include choice of music and imagery, which should cross age, gender, and cultural boundaries.

Educate staff

Staff education, as well new employee orientation, should make the staff aware of their responsibility for maintaining an appropriate sound environment This remit would include standards governing private or confidential discussions that take place in public areas, the use and methods of paging, and the use of cell phones and nurse call systems.

One enlightened US hospital produced a highly effective educational video that demonstrated the best and worst behavioural examples, but there are gentler methods to give the message to visitors. Another hospital facility in the US put up an ornamental post, or stanchion, of a child in a colourful nursing uniform holding one finger to her lips and saying 'Shhh!' Another created signs and buttons saying 'Quiet Please: Healing in Progress:

CONCLUSION

The sound environment is the least controllable and most pervasive, if not invasive, of all environmental stressors in the clinical setting. Whether trying to control breakthrough pain caused by cancer or agitation caused by other conditions, the sounds that surround patients and caregivers impact bottom-line effectiveness.

The long-term success of the eight steps described above are dependent upon continuing diligence. Re-assess the sound environment; re-evaluate the effectiveness of methods being used; maintain equipment as it ages; pay attention to patient satisfaction scores specific to the sound environment; and regularly include the quality of the sound environment as an agenda item in staff management meetings, as well as other staff meetings. This will assure that the quality of care will be well represented by what is heard as well as seen.