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Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle
Objectives: Noise pollution in pediatric intensive care units (PICU) contributes to poor sleep and may increase risk of developing delirium. The Environmental Protection Agency (EPA) recommends
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| Published in: | Journal of Intensive Care Medicine 2019-05, Vol.34 (5), p.383-390 |
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| cites | cdi_FETCH-LOGICAL-c337t-36548852e95f7641c9de2ff36f00dc39192656fde02530eee680ae96825bfc273 |
| container_end_page | 390 |
| container_issue | 5 |
| container_start_page | 383 |
| container_title | Journal of Intensive Care Medicine |
| container_volume | 34 |
| creator | Kawai, Yu Weatherhead, Jeffrey R. Traube, Chani Owens, Tonie A. Shaw, Brenda E. Fraser, Erin J. Scott, Annette M. Wojczynski, Melody R. Slaman, Kristen L. Cassidy, Patty M. Baker, Laura A. Shellhaas, Renee A. Dahmer, Mary K. Shever, Leah L. Malas, Nasuh M. Niedner, Matthew F. |
| description | Objectives:
Noise pollution in pediatric intensive care units (PICU) contributes to poor sleep and may increase risk of developing delirium. The Environmental Protection Agency (EPA) recommends |
| doi_str_mv | 10.1177/0885066617728030 |
| format | article |
| fullrecord | <record><control><sourceid>sage_cross</sourceid><recordid>TN_cdi_crossref_primary_10_1177_0885066617728030</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0885066617728030</sage_id><sourcerecordid>10.1177_0885066617728030</sourcerecordid><originalsourceid>FETCH-LOGICAL-c337t-36548852e95f7641c9de2ff36f00dc39192656fde02530eee680ae96825bfc273</originalsourceid><addsrcrecordid>eNp1kMtOwzAQRS0EoqWwZ4X8AwE_aidZQnlVqniJimXkJmPqKokr26nULV-OowJCSKxmNOfe0cxF6JSSc0rT9IJkmSBSytizjHCyh4ZUMJHQcZbvo2GPk54P0JH3K0IoZ5weogGLIBdpNkQfz52qTdjiabN2dgMNtAFPWxOMCmYDOFj8AlVXAn6CKs6cKSMO0PqeTpQDPI9q_GCNjxpb110wtsVvJixxWEYax1Zj9ct_DbVxpmvwVddWNRyjA61qDydfdYTmtzevk_tk9ng3nVzOkpLzNCRcinE8m0EudCrHtMwrYFpzqQmpSp7TnEkhdQWECU4AQGZEQS4zJha6ZCkfIbLbWzrrvQNdrJ1plNsWlBR9nMXfOKPlbGdZd4sGqh_Dd35RkOwEXr1DsbKda-ML_y_8BF10fdk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle</title><source>Sage Journals Online</source><creator>Kawai, Yu ; Weatherhead, Jeffrey R. ; Traube, Chani ; Owens, Tonie A. ; Shaw, Brenda E. ; Fraser, Erin J. ; Scott, Annette M. ; Wojczynski, Melody R. ; Slaman, Kristen L. ; Cassidy, Patty M. ; Baker, Laura A. ; Shellhaas, Renee A. ; Dahmer, Mary K. ; Shever, Leah L. ; Malas, Nasuh M. ; Niedner, Matthew F.</creator><creatorcontrib>Kawai, Yu ; Weatherhead, Jeffrey R. ; Traube, Chani ; Owens, Tonie A. ; Shaw, Brenda E. ; Fraser, Erin J. ; Scott, Annette M. ; Wojczynski, Melody R. ; Slaman, Kristen L. ; Cassidy, Patty M. ; Baker, Laura A. ; Shellhaas, Renee A. ; Dahmer, Mary K. ; Shever, Leah L. ; Malas, Nasuh M. ; Niedner, Matthew F.</creatorcontrib><description>Objectives:
Noise pollution in pediatric intensive care units (PICU) contributes to poor sleep and may increase risk of developing delirium. The Environmental Protection Agency (EPA) recommends <45 decibels (dB) in hospital environments. The objectives are to assess the degree of PICU noise pollution, to develop a delirium bundle targeted at reducing noise, and to assess the effect of the bundle on nocturnal noise pollution.
Methods:
This is a QI initiative at an academic PICU. Thirty-five sound sensors were installed in patient bed spaces, hallways, and common areas. The pediatric delirium bundle was implemented in 8 pilot patients (40 patient ICU days) while 108 non-pilot patients received usual care over a 28-day period.
Results:
A total of 20,609 hourly dB readings were collected. Hourly minimum, average, and maximum dB of all occupied bed spaces demonstrated medians [interquartile range] of 48.0 [39.0-53.0], 52.8 [48.1-56.2] and 67.0 [63.5-70.5] dB, respectively. Bed spaces were louder during the day (10AM to 4PM) than at night (11PM to 5AM) (53.5 [49.0-56.8] vs. 51.3 [46.0-55.3] dB, P < 0.01). Pilot patient rooms were significantly quieter than non-pilot patient rooms at night (n=210, 45.3 [39.7-55.9]) vs. n=1841, 51.2 [46.9-54.8] dB, P < 0.01). The pilot rooms compliant with the bundle had the lowest hourly nighttime average dB (44.1 [38.5-55.5]).
Conclusions:
Substantial noise pollution exists in our PICU, and utilizing the pediatric delirium bundle led to a significant noise reduction that can be perceived as half the loudness with hourly nighttime average dB meeting the EPA standards when compliant with the bundle.</description><identifier>ISSN: 0885-0666</identifier><identifier>EISSN: 1525-1489</identifier><identifier>DOI: 10.1177/0885066617728030</identifier><identifier>PMID: 28859578</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Child ; Delirium - etiology ; Delirium - prevention & control ; Female ; Humans ; Intensive Care Units, Pediatric - standards ; Male ; Noise - adverse effects ; Noise - prevention & control ; Patient Care Bundles - instrumentation ; Patients' Rooms - standards ; Pilot Projects ; Quality Improvement</subject><ispartof>Journal of Intensive Care Medicine, 2019-05, Vol.34 (5), p.383-390</ispartof><rights>The Author(s) 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-36548852e95f7641c9de2ff36f00dc39192656fde02530eee680ae96825bfc273</citedby><cites>FETCH-LOGICAL-c337t-36548852e95f7641c9de2ff36f00dc39192656fde02530eee680ae96825bfc273</cites><orcidid>0000-0002-5452-0867</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,315,786,790,798,27955,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28859578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawai, Yu</creatorcontrib><creatorcontrib>Weatherhead, Jeffrey R.</creatorcontrib><creatorcontrib>Traube, Chani</creatorcontrib><creatorcontrib>Owens, Tonie A.</creatorcontrib><creatorcontrib>Shaw, Brenda E.</creatorcontrib><creatorcontrib>Fraser, Erin J.</creatorcontrib><creatorcontrib>Scott, Annette M.</creatorcontrib><creatorcontrib>Wojczynski, Melody R.</creatorcontrib><creatorcontrib>Slaman, Kristen L.</creatorcontrib><creatorcontrib>Cassidy, Patty M.</creatorcontrib><creatorcontrib>Baker, Laura A.</creatorcontrib><creatorcontrib>Shellhaas, Renee A.</creatorcontrib><creatorcontrib>Dahmer, Mary K.</creatorcontrib><creatorcontrib>Shever, Leah L.</creatorcontrib><creatorcontrib>Malas, Nasuh M.</creatorcontrib><creatorcontrib>Niedner, Matthew F.</creatorcontrib><title>Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle</title><title>Journal of Intensive Care Medicine</title><addtitle>J Intensive Care Med</addtitle><description>Objectives:
Noise pollution in pediatric intensive care units (PICU) contributes to poor sleep and may increase risk of developing delirium. The Environmental Protection Agency (EPA) recommends <45 decibels (dB) in hospital environments. The objectives are to assess the degree of PICU noise pollution, to develop a delirium bundle targeted at reducing noise, and to assess the effect of the bundle on nocturnal noise pollution.
Methods:
This is a QI initiative at an academic PICU. Thirty-five sound sensors were installed in patient bed spaces, hallways, and common areas. The pediatric delirium bundle was implemented in 8 pilot patients (40 patient ICU days) while 108 non-pilot patients received usual care over a 28-day period.
Results:
A total of 20,609 hourly dB readings were collected. Hourly minimum, average, and maximum dB of all occupied bed spaces demonstrated medians [interquartile range] of 48.0 [39.0-53.0], 52.8 [48.1-56.2] and 67.0 [63.5-70.5] dB, respectively. Bed spaces were louder during the day (10AM to 4PM) than at night (11PM to 5AM) (53.5 [49.0-56.8] vs. 51.3 [46.0-55.3] dB, P < 0.01). Pilot patient rooms were significantly quieter than non-pilot patient rooms at night (n=210, 45.3 [39.7-55.9]) vs. n=1841, 51.2 [46.9-54.8] dB, P < 0.01). The pilot rooms compliant with the bundle had the lowest hourly nighttime average dB (44.1 [38.5-55.5]).
Conclusions:
Substantial noise pollution exists in our PICU, and utilizing the pediatric delirium bundle led to a significant noise reduction that can be perceived as half the loudness with hourly nighttime average dB meeting the EPA standards when compliant with the bundle.</description><subject>Child</subject><subject>Delirium - etiology</subject><subject>Delirium - prevention & control</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units, Pediatric - standards</subject><subject>Male</subject><subject>Noise - adverse effects</subject><subject>Noise - prevention & control</subject><subject>Patient Care Bundles - instrumentation</subject><subject>Patients' Rooms - standards</subject><subject>Pilot Projects</subject><subject>Quality Improvement</subject><issn>0885-0666</issn><issn>1525-1489</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kMtOwzAQRS0EoqWwZ4X8AwE_aidZQnlVqniJimXkJmPqKokr26nULV-OowJCSKxmNOfe0cxF6JSSc0rT9IJkmSBSytizjHCyh4ZUMJHQcZbvo2GPk54P0JH3K0IoZ5weogGLIBdpNkQfz52qTdjiabN2dgMNtAFPWxOMCmYDOFj8AlVXAn6CKs6cKSMO0PqeTpQDPI9q_GCNjxpb110wtsVvJixxWEYax1Zj9ct_DbVxpmvwVddWNRyjA61qDydfdYTmtzevk_tk9ng3nVzOkpLzNCRcinE8m0EudCrHtMwrYFpzqQmpSp7TnEkhdQWECU4AQGZEQS4zJha6ZCkfIbLbWzrrvQNdrJ1plNsWlBR9nMXfOKPlbGdZd4sGqh_Dd35RkOwEXr1DsbKda-ML_y_8BF10fdk</recordid><startdate>201905</startdate><enddate>201905</enddate><creator>Kawai, Yu</creator><creator>Weatherhead, Jeffrey R.</creator><creator>Traube, Chani</creator><creator>Owens, Tonie A.</creator><creator>Shaw, Brenda E.</creator><creator>Fraser, Erin J.</creator><creator>Scott, Annette M.</creator><creator>Wojczynski, Melody R.</creator><creator>Slaman, Kristen L.</creator><creator>Cassidy, Patty M.</creator><creator>Baker, Laura A.</creator><creator>Shellhaas, Renee A.</creator><creator>Dahmer, Mary K.</creator><creator>Shever, Leah L.</creator><creator>Malas, Nasuh M.</creator><creator>Niedner, Matthew F.</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><orcidid>https://orcid.org/0000-0002-5452-0867</orcidid></search><sort><creationdate>201905</creationdate><title>Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle</title><author>Kawai, Yu ; Weatherhead, Jeffrey R. ; Traube, Chani ; Owens, Tonie A. ; Shaw, Brenda E. ; Fraser, Erin J. ; Scott, Annette M. ; Wojczynski, Melody R. ; Slaman, Kristen L. ; Cassidy, Patty M. ; Baker, Laura A. ; Shellhaas, Renee A. ; Dahmer, Mary K. ; Shever, Leah L. ; Malas, Nasuh M. ; Niedner, Matthew F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-36548852e95f7641c9de2ff36f00dc39192656fde02530eee680ae96825bfc273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Child</topic><topic>Delirium - etiology</topic><topic>Delirium - prevention & control</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units, Pediatric - standards</topic><topic>Male</topic><topic>Noise - adverse effects</topic><topic>Noise - prevention & control</topic><topic>Patient Care Bundles - instrumentation</topic><topic>Patients' Rooms - standards</topic><topic>Pilot Projects</topic><topic>Quality Improvement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawai, Yu</creatorcontrib><creatorcontrib>Weatherhead, Jeffrey R.</creatorcontrib><creatorcontrib>Traube, Chani</creatorcontrib><creatorcontrib>Owens, Tonie A.</creatorcontrib><creatorcontrib>Shaw, Brenda E.</creatorcontrib><creatorcontrib>Fraser, Erin J.</creatorcontrib><creatorcontrib>Scott, Annette M.</creatorcontrib><creatorcontrib>Wojczynski, Melody R.</creatorcontrib><creatorcontrib>Slaman, Kristen L.</creatorcontrib><creatorcontrib>Cassidy, Patty M.</creatorcontrib><creatorcontrib>Baker, Laura A.</creatorcontrib><creatorcontrib>Shellhaas, Renee A.</creatorcontrib><creatorcontrib>Dahmer, Mary K.</creatorcontrib><creatorcontrib>Shever, Leah L.</creatorcontrib><creatorcontrib>Malas, Nasuh M.</creatorcontrib><creatorcontrib>Niedner, Matthew F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Journal of Intensive Care Medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawai, Yu</au><au>Weatherhead, Jeffrey R.</au><au>Traube, Chani</au><au>Owens, Tonie A.</au><au>Shaw, Brenda E.</au><au>Fraser, Erin J.</au><au>Scott, Annette M.</au><au>Wojczynski, Melody R.</au><au>Slaman, Kristen L.</au><au>Cassidy, Patty M.</au><au>Baker, Laura A.</au><au>Shellhaas, Renee A.</au><au>Dahmer, Mary K.</au><au>Shever, Leah L.</au><au>Malas, Nasuh M.</au><au>Niedner, Matthew F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle</atitle><jtitle>Journal of Intensive Care Medicine</jtitle><addtitle>J Intensive Care Med</addtitle><date>2019-05</date><risdate>2019</risdate><volume>34</volume><issue>5</issue><spage>383</spage><epage>390</epage><pages>383-390</pages><issn>0885-0666</issn><eissn>1525-1489</eissn><abstract>Objectives:
Noise pollution in pediatric intensive care units (PICU) contributes to poor sleep and may increase risk of developing delirium. The Environmental Protection Agency (EPA) recommends <45 decibels (dB) in hospital environments. The objectives are to assess the degree of PICU noise pollution, to develop a delirium bundle targeted at reducing noise, and to assess the effect of the bundle on nocturnal noise pollution.
Methods:
This is a QI initiative at an academic PICU. Thirty-five sound sensors were installed in patient bed spaces, hallways, and common areas. The pediatric delirium bundle was implemented in 8 pilot patients (40 patient ICU days) while 108 non-pilot patients received usual care over a 28-day period.
Results:
A total of 20,609 hourly dB readings were collected. Hourly minimum, average, and maximum dB of all occupied bed spaces demonstrated medians [interquartile range] of 48.0 [39.0-53.0], 52.8 [48.1-56.2] and 67.0 [63.5-70.5] dB, respectively. Bed spaces were louder during the day (10AM to 4PM) than at night (11PM to 5AM) (53.5 [49.0-56.8] vs. 51.3 [46.0-55.3] dB, P < 0.01). Pilot patient rooms were significantly quieter than non-pilot patient rooms at night (n=210, 45.3 [39.7-55.9]) vs. n=1841, 51.2 [46.9-54.8] dB, P < 0.01). The pilot rooms compliant with the bundle had the lowest hourly nighttime average dB (44.1 [38.5-55.5]).
Conclusions:
Substantial noise pollution exists in our PICU, and utilizing the pediatric delirium bundle led to a significant noise reduction that can be perceived as half the loudness with hourly nighttime average dB meeting the EPA standards when compliant with the bundle.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>28859578</pmid><doi>10.1177/0885066617728030</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5452-0867</orcidid></addata></record> |
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| identifier | ISSN: 0885-0666 |
| ispartof | Journal of Intensive Care Medicine, 2019-05, Vol.34 (5), p.383-390 |
| issn | 0885-0666 1525-1489 |
| language | eng |
| recordid | cdi_crossref_primary_10_1177_0885066617728030 |
| source | Sage Journals Online |
| subjects | Child Delirium - etiology Delirium - prevention & control Female Humans Intensive Care Units, Pediatric - standards Male Noise - adverse effects Noise - prevention & control Patient Care Bundles - instrumentation Patients' Rooms - standards Pilot Projects Quality Improvement |
| title | Quality Improvement Initiative to Reduce Pediatric Intensive Care Unit Noise Pollution With the Use of a Pediatric Delirium Bundle |
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