Noisy treatment in hospitals

Loud patient rooms and floors can hinder restful recuperations

October 31, 2011|By Liz Kowalczyk, Globe Staff

For patients recovering from an illness or surgery, doctors first and foremost prescribe rest. But in many hospitals, noise from alarms on patient monitors, other equipment, and conversations is so loud that patients can’t sleep and end up heading home exhausted.

It’s been known for years that hospitals can be loud at night, but evidence is growing that noise on patient floors routinely exceeds the World Health Organization’s recommended maximum of 40 decibels for hospital rooms.

The VA Boston Healthcare System installed noise meters in a nine-bed unit earlier this year and recorded nighttime noise levels up to 66 decibels in hallways - similar to the sound of an alarm clock blaring - and 74 decibels in the loudest patient room. Before improvements on the unit, nurses described it as “extremely noisy’’ and said if they were a patient, they would not be able to heal.

A previous study at Johns Hopkins Hospital in Baltimore found nighttime noise reached 70 decibels in five cancer, pediatric, and medical surgical units.

A leading acoustician who spoke this month at a national health care meeting, where VA staff discussed their findings, said that hospitals are about three times louder at night now than they were when measurements were first taken in 1960.

A lot of the noise is from alarms on monitors that measure heart function and blood oxygen levels, pumps that deliver intravenous medications, and overhead pagers that broadcast alerts. Some of the veterans who filled out questionnaires about the most bothersome noises at the Boston VA simply wrote “alarms,’’ “beeping,’’ or “bells.’’

While monitors can save lives when they alert nurses to dangerous changes in a patient, more than 80 percent of these alarms are false or nuisance alarms, meaning nothing is wrong. The constant beeping desensitizes nurses, causing them to tune out the occasional alarms that turn out to be critical - a phenomenon called “alarm fatigue’’ that is linked to hundreds of patient deaths, according to a Globe investigation published earlier this year.

But the constant beeping - along with noise from staff conversations, ringing telephones, equipment carts with squeaky wheels, and powerful air conditioning systems - may be harming many more patients in subtler ways. Research has shown that depriving people of sleep weakens their immune systems. One study found that healthy adults vaccinated for Hepatitis A produced fewer antibodies to the virus if they were deprived of sleep the night after vaccination.