A mixed-method assessment of a night-time noise reduction intervention in an acute medical ward

<p dir="ltr">Background: Research has shown that noise & interruptions in hospital settings can have a detrimental impact on patients' sleep and recovery. Insufficient sleep can lead to slower recovery and reduced production of growth hormones, which is vital for recovery. However, prior research has predominantly focused on the perspectives of researchers and patients regarding noise & interruptions in hospitals, with some blaming the staff for causing the noise & interruptions. In addition, noise reduction interventions have reduced noise levels, claiming that the reduction was due to changes in staff behaviour. Yet this claim lacks evidence, and further exploration of the views and experiences of the staff involved is required to fill the evidence and knowledge gaps to the claim.</p><p dir="ltr">Aim: To address these gaps, the current study introduces a Sound-Activated Noise Display (SAND) device in an Acute Medical Unit (AMU) to raise staff awareness and explore staff experiences of noise levels.</p><p dir="ltr">Method: An explanatory sequential mixed-method design was used to collect the data within five phases of the study. The data were analysed using both SPSS and Framework Analysis. The findings were combined using a visual joint display.</p><p dir="ltr">Results: The quantitative analysis revealed non-compliance of the current noise levels in AMU to the World Health Organisation (WHO) and Environmental Protection Agency (EPA) recommended noise levels, confirming previous findings that the recommended levels were too low for hospital settings. Furthermore, there was a consistent reduction of peak count noise levels throughout the study phases. In addition, the qualitative analysis revealed three broad categories of noise sources: Relational, functional, and structural noise & interruptions. Participants reported encountering two difficulty levels with the effort to reduce noise in the unit: personal and institutional challenges when dealing with these sources.</p><p dir="ltr">Conclusion: Reducing night-time noise levels in AMU requires a complex strategy. Therefore, a new 5-SNR-Model-02 was developed from this research to address the issue of noise & interruptions in hospital settings in general. However, for its success, it requires support and engagement from all levels of healthcare services: the micro (individual), the meso (institutional), and the macro (policy) levels.</p>