CS120 - There's a Kind of Hush.......Quiet Time in the MICU
Primary Author: Parvaneh Mostaghimi
Co-Author(s): Stephanie Niemchak
Institution: Duke University Hospital, Durham, NC
Contact Email: mosta001@mc.duke.edu
Purpose: Our Medical Intensive Care Unit (MICU) was constantly flooded with the noise of a multidisciplinary, collaborative team hard at work. In our 16 bed MICU, procedures, teaching and activity occurred 24/7, sometimes resulting in patient and family complaints. This often prevented patients from receiving the rest they needed to quickly recover to their optimal health. Health Care Providers, students, visiting scholars and well meaning families all contributed to an ever increasing noise level.
Description: In order to provide a Healthy Work Environment, our noise problem had to be first acknowledged. We obtained the cooperation of unit leadership, as well as our Medical Director. After an extensive search of the literature, the idea of MICU Quiet Time was successfully introduced at our monthly staff meeting in March of 2008. We then asked the Occupational and Environmental Safety Office, (OESO) to evaluate the noise level in the MICU at different times of the day for several days. The eight hour time weighted average was 60.2-64.8 decibels, (dB) with the threshold for hazardous noise being 85 dB. We announced our plan to go live on April 1, 2008 to the members of the MICU team. We then implemented the quiet time from 2pm -4pm daily and set rules for staff and visitors. For two hours a day we dimmed lights, decreased phone ring volumes, silenced beepers, avoided over-head pages, rescheduled none emergent procedures, pulled down blinds and played soft music while the televisions were turned off. Families were educated about Quiet Time upon admission, and encouraged to use that time for personal errands, meals and rest themselves. Staff were encouraged to use that time for documentation, meal breaks and continuing education.
Evaluation/Outcomes: After one quarter of implementing MICU Quiet Time, a survey was conducted with staff and families. 85% of families approved of the plan, while 100% of the staff stated that quiet time helps them to provide better care in a controlled environment. The OESO also returned to measure the noise level during quiet-time, and it was 58-58.3 dB post quiet-time, “markedly less than the” 60.2-64.8 dB pre quiet-time. Our patients are getting some much needed rest, our families get a scheduled break, our unit is quieter, and staff now have precious time designated for necessary documentation, breaks and continuing education. A Healthy Work Environment indeed!
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