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A1465 - Time Spent Asleep at Night Increases with Lower Hospital Noise
Author Block: A. Dawson1, G. Arthur2, T. Terwilliger3, M. Decavalcante1, S. Hammerman4; 1Quality and Healthcare Analytics, Select Medical, Mechanicsburg, PA, United States, 2Analytics, Harrisburg University, Harrisburg, PA, United States, 3Select Medical, Mechanicsburg, PA, United States, 4LTACH Division, Select Medical, Mechanicsburg, PA, United States.
In order to develop a plan of care that addresses modifiable factors causing sleep deprivation, an initiative to improve sleep by reducing nighttime noise levels was implemented in a long-term acute care hospital. Over six weeks, noise measurements were taken for patient rooms closest to the nursing stations, and hours of nighttime sleep were scored from telemetry readings of heart rate, respiratory rate and sleep apnea. After baseline measurements, online visual feedback of decibels in excess of therapeutic thresholds was displayed, and weekly noise summary reports were reviewed during morning huddle. Strategies to encourage regular sleep-wake cycles and reduce noise were discussed with all staff. At baseline, Nighttime Noise Decibel Level (dBA Leq) was 54.1 dB [SE=0.2] and Hours of Nighttime Sleep were 6.3 hrs. [SE=0.2]. After the noise reduction initiative was introduced and feedback was provided, Nighttime Noise Decibel Level non-significantly increased to 55.0 dB [SE=0.2] and Hours of Nighttime Sleep non-significantly decreased to 6.0 hrs. [SE=0.2]. In order to investigate the impact of noise on sleep, a generalized estimating equation was used to determine that Hours of Nighttime Sleep significantly depended on Noise Decibel Level (Nighttime LAeq max/hr), controlling for time at night and proximity of noise to the patients’ rooms, (β=-.08, SE=.04, p =.031). An analysis of the impact of noise on sleep revealed that the odds of a patient being asleep given a one unit increase in noise decibel level were almost 8% lower than if there was no change in decibel level. Noise abatement strategies and different feedback mechanisms were unsuccessful at reducing noise levels, such that nighttime noise levels remained in excess of existing hospital noise guidelines which range from 30-45dB. The importance of reducing nighttime noise in order to improve sleep quantity was supported by results directly relating noise levels to the likelihood of being sleep. Improvement in nighttime noise in high traffic areas of the hospital may require additional noise interventions aimed at addressing environmental sources and attenuating the effect of noise on patients.