During my clinical experiences an issue in the intensive care units that has been constant and not addressed is high noise levels and its contribution to a reduction in rest and therefore patient outcomes. At my clinical rotation I met a 49-year-old patient who complained to me about the noise levels of the unit. She complained about the monitor’s beeping and I.V fluid machines alarming loudly, the noise of the staff on the unit talking and joking loudly and completing tasks, and the constant interruptions in her room by staff throughout the day and night. Due to losing many hours of sleep and her normal sleep schedule being interrupted, her stress levels increased, and her blood pressure and heart rate raised. She also felt fatigue, which …show more content…
One Cardiac Care unit Nurse noted that patients who did not get enough sleep often had a longer length of stay and developed a mild delirium, when asked questions such as “May I take your blood pressure?” or “What is your name and date of birth?” patients would either be incoherent or uncooperative. When observed, Nurses would neglect to do simple acts to promote sleep such as turning on all three lights when drawing blood, for example, and walking out of the room when finished and leaving all three lights on. “Sleep deprivation is defined as a reduced ability to achieve nocturnal sleep, with increased wakefulness and altered sleep architecture resulting in a decrease in non-rapid eye movement and short wave sleep” (Pilkington, 2013, 35). Reducing noise levels in the hospital is imperative to nursing and health care because a lack of sleep is associated with high blood pressure, heart rate elevations, cardiovascular and coronary heart disease, decreased immune function, attention deficits, and depression (Buxton, 2012). A patient in particular that had been admitted to the Cardiac Care Unit various times for the year due to a recurrent lung infection developed feelings of sadness and helplessness about his current situation. He said “I do not want to live my life if I …show more content…
Many alert patients can be heard having loud conversations over the phone often disrupting other patients and at times staff. “The auditory environment of the 21st century hospital is substantially louder, more complex, and more difficult to control than that of Florence Nightingale’s time” (Mazer, 2012). In her work Mazer described unnecessary noise as ‘the most cruel absence of care’. Out of all the noises one may hear in the intensive care setting, beside monitor alarms and staff conversation was the most disruptive for patients. (Li, 2011). If a patient is continuously getting inadequate sleep, the sympathetic nervous system remains stimulated continuously, maintaining a high blood pressure, a rapid heart rate and systemic vascular resistance at a higher level than if the patient was getting sufficient rest (Pilkington,
Fontana, C. J. (2010). Sleep Deprivation Among Critical Care Patients. Critical Care Nursing Quarterly , 75-81.
In the Intensive Care Unit (ICU), patients are being monitored very closely while their vital signs, their neurological status, and their physical status are being managed with strong medications, lifesaving machines, and the clinical knowledge and skills of trained ICU nurses. Outside of the ICU, it is essential for staff nurses to identify the patient that is clinically deteriorating and in need of urgent intervention.
Hospitalized patients are often hooked up to monitoring devices such as heart monitors, which monitor the electric activity of the heart, or connected to a physiological monitor so their vital signs are constantly being measured. These monitors are intended to continuously assess the patients’ status, and alarm if the patients’ status drops below what is considered normal. The increased use of monitoring devices has created a new phenomenon known as alarm fatigue. According to the ECRI institute (2011), “alarm fatigue occurs when the sheer number of alarms overwhelms staff and they become desensitized to the alarms resulting in delayed alarm response and missed alarms-often resulting in patient harm or even death.” Alarm fatigue has become a major problem within the nursing community and has already had a negative impact on patient safety. Due to the adverse effects alarm fatigue is having on quality patient care, there has been a call to action to find solutions that may deter alarm fatigue. Evidence-based practices involving quality improvement initiatives have been put into effect. The problem has also gained national attention from such institutions as the Food and Drug Administration (FDA) and The Joint Commission (TJC).
This article has shown me that new strategies are needed to reduce sleep disturbances, improve sleep quality, and support the need for supplemental daytime sleep in hospitalized individuals. These strategies include monitoring patients’ sleep and assess quality of sleep and duration, resolving the problems of sleep disturbance, recognizing that nighttime noise, light, and other factors potentially interfere with patient sleep, minimize lighting in shared patient rooms and turn off lights earlier at night, frequently assess for pain and administer prescribed pain medications to minimize sleep disruption. This article taught me more about sleep cycles and disturbances in hospitalized patients. As a future nurse, I have to accurately assess the patients’ personal characteristics and health education needs, and share this knowledge with my classmates.
Journal of Critical Care, 503.) The leading causes of most errors among stress and interruption are other factors such as: wrong dosage, dose omissi...
While nurses are working on a floor there are many different machines that have alarms such as IV pumps, ventilator machines, ECG’s, vital machines, call lights, and pagers. New nurses have shown a lack of response efforts to combat these alarms from a proposed desensitization and sensory overload of the alarm noise (Cvach, 2012). This is a patient safety concern due to what the alarms purpose is which in turn leads to varying amounts of potentially severe consqeunces if not answered promptly. Between 2009 and 2012 the joint commission stated that there were 80 patient deaths, 13 permanent losses of function, and 5 events that led to extended hospital stays (Horkan, 2014). It is important for nurses to recognize alarm fatigue and find interventions to help keep patients from being injured.
...managing the environment for the benefit of the patient to help reduce risk factors. Supportive measures by the nurse such as attention to noise reduction and lighting should be implemented to all patient care settings. The nurse should be proficient in their assessment method. The bedside nurse is in a front-line position to manage and prevent delirium.
Nurses form an important role in influencing patient safety from everyday tasks and gradually obtaining the patient vital signs have increasingly been seen as a chore instead of collecting clinical evidence. This then creates an extreme danger to patient’s as irregular monitoring of vital signs prevented early detection of deterioration in a patient’s condition, which postpones transfer to intensive care unit ( Kyriacos U et al 2011; Boulanger, 2009). Due to this, a...
Initial Reflective Essay When I first thought of what I wanted to do with my life after college, the first thing I thought of was helping people. The next step in deciding what I wanted to do with my life was to examine how I could accomplish this goal. I started pondering and I was thinking about how much I love to take care of my body. Health care and personal hygiene has always been an important factor in my life. So I decided to major in Health Sciences.
Noise (Noise induced hearing loss NIHL): Another occupational hazard that contributes to workplace injury is excessive noise. Excessive noise may have adverse effects, which include, high blood pressure, stress, reduced performance and noise induced hearing loss. While there are other factors contributing to NIHL, the shortage of prevention is a high contributor. Engineering controls is one way of reducing noise at its source (Nelson et al. 20...
Alarms sound around-the-clock in acute care settings, subjecting staff to a constant barrage of noises in the workplace. Alarms were designed to alert providers of abnormal values; unfortunately, because of the high sensitivity of these devices, there is very low specificity. Low specificity coupled with the human factor compromises patient safety. When alarms are missed or when there is a delay in response, alarm fatigue is often to blame. This paper summarizes the factors contributing to alarm fatigue, the consequences of alarm fatigue, and the evidence-based interventions used to address alarm fatigue that were found within the literature. The paper closes with the application of the Quantum Leadership theory to the implementation process for one of the recommended evidence-based interventions found within the research.
A healing physical environment is a noise-free environment. The common challenge most hospitals face is how to provide and more importantly, how to maintain a quiet environment for patients. Excessive noise is unsettling and disrupts sleep and rest. Modifying visiting hours, for example, will allow more time for patients to rest. Limiting conversations outside of a patient room and eliminating overhead paging are other ways a quiet environment can be achieved. A noise-free environment not only benefits patients in promoting healing, it also has a positive impact to caregivers in providing a calmer environment (Eberst,
The first four weeks of CR510 have prompted this student to reflect on her years of teaching in the public school setting. Having experienced many similar complexities to the ones in the text, this student is sympathetic to the challenges facing those in the education system and is eager to find opportunities to offer a better solution for all involved. CR510 has strengthened this student's belief that a third party neutral can provide valuable benefits to educational systems at all levels.
According to Paul (1999), reflective practice has become a dominant paradigm in second language teacher education in recent years. Further, Biggs (2003) cited that learning new technique for teacing is like the fish that provides a meal for today which same as reflective practice that acts as the net that provides the meal for the rest of one’s life. To begin with, reflective practice has been a major movement since the eighties in teacher education (Calderhead, 1989; Cruickshank &Applegate, 1981; Gore, 1987; Zeichner, 1987). Even more, research acknowledges a number of potential benefits that arise from reflecting on ones’ teaching both for pre-service and in-service teachers (Bailey, 1997; Cruickshank, 1987; Mckay, 2002; Oterman and Kottamp,
A healing environment is free from disturbances and loud noises to allow the patient to sleep and have adequate rest. Sl...