While the environment of care is an area usually led by facilities-related departments, some patient care units are taking an active role in asserting what a good environment is — including how it sounds.
The Coronary Care Unit (CCU) has developed a daily “quiet hour” in the afternoons and is trying to reduce noise overall. Medical literature shows noise can adversely affect patients and staff, says Mary Beth Esposito-Herr, Ph.D., R.N., vice president for patient care services.
“I think the noise level throughout the hospital is important to our overall environment of care, and something that we can improve with small, easy steps, such as putting pagers in vibrate mode,” says Denise Choiniere, R.N., B.S.N., senior partner in the CCU, who proposed and led the effort to establish a quiet hour.
The quiet hour involves closing patient’s doors, dimming their lights and placing a “Do Not Disturb” sign on their doors. The unit staff dims the lights, turns down the telemetry alarm volume and disengages the automatic doors. There are no overhead pages, deliveries or non-emergency procedures permitted.
“It is about putting the patients’ need for rest before our own schedules and agendas,” Choiniere says. “This process-improvement initiative has been embraced by patients and staff on the unit. They look forward to the one hour of quiet time each day.”
Interest from other units has been growing. Choiniere says nurses who want to implement a quiet hour should be prepared to plan and coordinate across every department that sends anything or anyone to the unit, such as nutrition, respiratory therapy, pharmacy and linen.
“This has been so well received, it is overwhelming,” Choiniere says. “I am surprised at how easy it was to coordinate the ancillary departments not to make deliveries to the floor or not to see patients during our quiet hour. They are all willing to work with us on this, and it is very much appreciated.”
By Anne Haddad