Patient perception of nighttime noise in the hospital setting.

258 Background: The national standard survey, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), measures the patient's perspective on hospital care. One area that continually evokes sub-optimal results is the 'quiet at night' measurement. Our investigation explored the patient's perception of nighttime "noise" in the hospital setting.

METHODS: Patients in our medical surgical/telemetry floors subjectively evaluated the noise level at night. An ethnographic interview method was utilized that was approved and standardized to prevent bias. Results were stratified and coded.

RESULTS: A total of 224 patients completed the process prior to any intervention to provide our hospital with a baseline understanding of the current state. We then utilized two evidenced-based approaches which have been shown to decrease a patient's perception of noise: a sleep pack consisting of ear plugs, headphones, and a sleep mask, and one-on-one education on how to use the relaxation channel. Of the additional 101 patients who received this education, twenty-seven of these participants completed a second interview the following day, which allowed for comparison data to be compiled. By speaking with the patients, our investigation not only yielded information regarding the perception of noise level in their room, but additionally identified factors that were the cause of the noise. Although, our two interventions did not produce a positive change in noise level, it did provide valuable feedback and insight for quality initiatives.

CONCLUSIONS: Noise level is a quality issue which needs to be continually addressed. Our interdisciplinary team, along with nursing leadership, intends to move forward with developing a plan to promote an optimal healing environment.