The NHS provides lifesaving treatment, but noise in hospitals could be detrimental to patients' sleep and rest and their overall wellbeing. Inpatient surveys have shown a trend for worsening scores when it comes to being disturbed by noise (Raleigh et al, 2015). Noise in hospitals is inevitable to some extent, but in many situations could be reduced to allow the peace and quiet that patients desire. One factor is the rising use of technology to aid diagnosis and treatment—along with the benefits can come a good deal of noise pollution, from the devices themselves and the human activity associated with them. Excessive noise has undesirable effects on patients such as annoyance, impaired communication, irritation, fatigue and reduced quality of life (Xyrichis et al, 2018).
This commentary was prompted by a relative's account of the detrimental effects of noise he had endured as a patient at a hospital. One late evening my relative was admitted to a receiving unit for assessment and immediate treatment before being transferred to another ward. He recounted that, as he waited for a medical decision about the next level of care, he became acutely aware of the noise emanating from various sources; some faint, others intolerably annoying and distracting. Following assessment and treatment, he waited for the results of further medical tests and a final decision about his transfer to another ward. He decided it would be wise to rest as it was well into the night. As he settled, he was woken again by a loud noise from slamming doors and soon this was accompanied by another noise from the wheels of an approaching electronic sphygmomanometer. The nurse attached him to the machine, which triggered another noise when it was activated. He recollected that he was glad when this procedure was over and decided to get some sleep. As soon as he closed his eyes, he was woken again by the sound of the alarm set off by the intravenous (IV) equipment connected to him. The drip alarm went on and on for some time until a nurse intervened to stop it to replace the empty IV fluid bag. Then, he said, there were echoes of patients' buzzers drowning the ward with incessant noise.
My relative further reflected that he cherished the respite from noise after the IV drip episode and when the patients' buzzers ceased. Again, as it was getting into the early hours of the morning, he decided to try to sleep. But this was short lived, abruptly disrupted by a loud banging noise from the slamming doors. The noise from the motorised wheels of a patient's bed soon took over. Although this noise ceased it was replaced by a noisy conversation between a nurse and patient. As the conversation progressed it became louder and he was able to hear every word. He recalled that what he heard was interesting, but it kept him awake. Eventually this noise faded, and he finally caught up with some sleep. Soon after the nurse woke up him to bring the welcome news about his transfer to another ward. Although exhausted and irritable due to the noise and sleep deprivation he felt relieved and found the other ward to be less noisy.
What can be done? Some thoughtful measures could minimise noise on the wards. Trolleys are a necessary part of hospital activities where patients need to be transported between wards and departments for investigations. However, a relatively easy solution would be to introduce motorised trolleys with sound filters and well-lubricated wheels. These simple measures could subdue noise. Doors are necessary for security when entry requires monitoring and control. However, common-sense measures such as due care when opening and closing doors reduce noise, as may well-maintained door hinges.
Electronic sphygmomanometers, IV stands, and other electronic devices could have the technology to monitor patients from the nurses' station or be linked to mobile devices with apps to alert nurses. There is no need for gadgets with noisy systems in this age of technological innovation. Likewise, patients' buzzers could be linked to the nurses' station and mobile devices with blinking lights and vibrations to indicate where attention is required. Noise generated by human activities could be controlled by small gestures such as thoughtful consideration when holding conversations, phone calls and moving about.
Nurse and healthcare education curricula could incorporate space to address noise pollution in hospitals as well as a focus on staff measures to curtail noise. There could be further research and development into the causes of noise and its reduction. Staff awareness and development programmes could address this problem. Noise-reduction strategies should be on the agenda of all hospitals to promote patients' wellbeing.