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,
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.
Fontana, C. J. (2010). Sleep Deprivation Among Critical Care Patients. Critical Care Nursing Quarterly , 75-81.
There are events, subtle or otherwise, leading up to a critical change in health status. As nurses at the bedside, we must have strategies and protocols implemented in order to monitor changes in vital signs and trends leading towards a cardiac, respiratory, or neurologic event. In a hospital setting, patients are monitored for changes in condition, whether it be improvement or deterioration, allowing clinicians to decide the course of action to follow in their care.
Alarm fatigue is a growing problem that causes nurses to feel overwhelmed and not perform to the best of their abilities. Many people don’t understand the concept of alarm fatigue until they are in a hospital and hear the different noises going on first hand. Alarm fatigue occurs when nurses or other health care members have sensory overload due to the alarms, which then lead to ignoring the alarms raising concerns with patient safety (Horkan, 2014).
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).
Journal of Critical Care, 503.) The leading causes of most errors among stress and interruption are other factors such as: wrong dosage, dose omissi...
...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.
Although nurses and other health care workers can control only a small percentage of false alarms that lead to alarm fatigue, staff can help reduce the number of these alarms and increase patient safety through the application of the aforementioned evidence-based interventions. As supported by the literature, nurse leader-managers must make addressing alarm fatigue a top priority in their units and hospitals. Alarm fatigue is a serious issue in this age of information and will only become more relevant as complex technology becomes more and more standard in an increasing number of hospitals. Without more research and new developments in alarm algorithms, alarm fatigue will continue to be a significant problem. Because medical device companies are pressured to develop products with extremely high sensitivity to reduce their own liability, this barrier is a difficult one to address (Imhoff, 2009). Despite this momentous obstacle, nurses can still advocate for better alarm management systems and for greater advancement in this area of patient
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...
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,
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,
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...
A healing environment is free from disturbances and loud noises to allow the patient to sleep and have adequate rest. Sl...
Grossbach, I., Stranberg, S., & Chlan, L. (2011). Promoting Effective Communication for Patients Receiving Mechanical Ventilation. Critical Care Nurse, 31(3), 46-61. doi: 10.4037/ccn2010728