Assessment Of Noise Of Cardiac Hospital : A Case Study For An Indian City

Environmental Factors: The hospital is a very busy place. The background noise can distract the attention of the physicians while they ponder over the right prescription of a drug. The high demand of a medical profession can be stressful and lead to fatigue. These possible occupational hazards can contribute to medical errors.

378). Hospitals have an array of medical devices at the bedside that have alarms, which have grown significantly within recent years. Nurses may be exposed to over 350 physiologic alarm monitors per day, resulting in sensory overload thus leading to desensitization. When the alarm sounds it should be corrected immediately, even though it may be a false alarm or no issues with the patient. The Joint Commission has identified alarm fatigue as a 2014 National Patient Safety Goal, requiring hospitals “to establish improvement of alarm system safety as an organization priority” (as cited in Horkan, 2014, p. 83). Alarms are deliberately designed for high sensitivity so that nurses do not miss a true event. Firing alarms are usually muted, disabled or ignored by nurses altogether because alarms are viewed as a nuisance. Alarm hazards have generated national attention, in one highly publicized case an alarm sounded for 75 minutes before a nurse responded to a patient’s heart monitor that needed a battery replaced. When the nurse finally went to change the battery the patient was found unresponsive and could not be resuscitated because he had gone into cardiac arrest (Sendelbach & Funk, 2013). The patient’s heart monitor battery eventually died and did not issue the critical alarm alert. In another event, a patient fell getting out of bed and bleed to death because the nurse

Conceptual analysis is integral in understanding nursing theory. According to Walker and Avant (1995), concept analysis allows nursing scholars to examine the attributes or characteristics of a concept. It can be used to evaluate a nursing theory and allows for examination of concepts for relevance and fit within the theory. The phenomena of pain will be discussed in this paper and how it relates to the comfort theory.

In Cvach’s (2012) article, an integrated review synthesized research and non-research findings of seventy-two articles, published between 1/1/2000 and 10/1/2011. The author used the John Hopkins Nursing Evidence Based-Practice model to measure and evaluate the articles for this review. The data collected were categorized into 5 main themes: excessive alarms and the effects on nurses, nurse's response to alarms, alarm sounds and audibility, technology to reduce false alarms, and alarm notification system (Cvach, 2012). The purpose of this integrated review was to find out if the volume of noise (false alarms vs true alarms) disrupts the nurse’s response and perception to physiologic clinical alarms. The 3 main recommendations provided by the researcher were to implement the use of smart technology, generate change within the hospital's environment and protocols, and use of precautionary measures by healthcare staff in order to reduce monitor alarm fatigue.

The article “Dance of the call bells, using ethnography to evaluate patient satisfaction with quality of care” suggest the Key phenomenon and group under the study, by stating dance of the call bells, referring to the amount of times in a shift the call bells would ring and the group that it affects most are the patients. The title states how the call bells interfere with a patient opinion on whether quality care was received.

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

Pain is a condition that is determined and described by the person reporting it. There are several components to pain including the emotional, psychological, and physical aspects. Many health professionals struggle to understand this phenomenon and thereby insert their own perspectives into the pain assessment of patient reporting pain. The Affordable Care Act (ACA) (2010), also titled the Patient Protection and Affordable Care Act H.R. 3590, was passed by Congress and signed into law on March 23, 2010 (U.S. Department of Health and Human Services (DHHS), 2013). Hospital value based purchasing programs (VBP) were developed to align patient quality care and outcomes to the support initiatives from the ACA. A component of the VBP includes patient satisfaction. Patient satisfaction is a self-reported response to questionnaire administered by a third party. Many hospitals utilize Press Ganey to administer the survey for the inpatient and outpatient patients. One component the survey includes patient’s self-reporting how well their pain was managed during their hospitalization. This measure of satisfaction can have an adverse effect on patient outcomes and increase opioid use in this setting. Patient satisfaction and pain management are both subjective however pain management while within scope of healthcare professionals should not be included in the patient satisfaction survey.

In the article “Sleepless in Stepdown” written by Joanne Matukaitis, MSN, RN, FABC, NE-BC; Thea Eckman, MSN, RN, CCRN; Kristan Baxter, BSN, CCRN-CSC; Elisabeth Bradley, MS, RN, APN; Helen Hawrylack, BSN, CCRN; Sharmila Johnson, MSN, RN, APN, CCRN; Ruth Mooney, PhD, MN, RN-BC; Donna Papanicolas, RN, and Patricia Brigss, MSN, RN, CCRN, HTP, discuss issues of possible sleep disturbances in the recovery process in the hospital. Their theory basically says that sleep disturbances may lead to extended stays in the hospital, but also how the patient recovers in the process. The authors’ also address the fact that physiologic, behavioral, and functional outcomes may also be influenced by sleep disturbance.

This paper examines this culture of alarm fatigue among nurses in clinical care areas and the resulting potential for harm among the patient population. Although alarm fatigue may happen in any clinical area with frequent or repetitive alarms, this paper focuses on the phenomenon in critical care. The broad scope of this issue coupled with the high risk of patient harm demands insight and action from the nursing profession. By discussion and review of contributing factors such as repetitive alarms, noise level, lack of individualized settings, poorly configured devices, and desensitization of nurses, healthcare providers can strategize methods to prevent patient harm resulting from alarm fatigue. These measures also promote efficiency

The study used 19 individuals with unexplained chest pain from a university hospital in Western Sweden. The qualitative approach was to gain a deeper understanding of patients’ experience of unexplained chest pain. The study used 11 men and eight women admitted to the emergency department, and the quantitative method makes it possible to gain knowledge about this experience of pain that complements the quantitative data

Despite recent advances in information regarding perioperative care, postoperative pain continues to go undermanaged. Postoperative pain is the pain patients experience after a surgical procedure. According to Gan, 80% of all people who undergo surgeries experience postoperative pain, and 75% of them rate their pain at a moderate, severe, or extreme level (as cited by Cooney, 2016). Furthermore, inadequately managed pain can lead to patient dissatisfaction, decreased patient outcomes, and overall higher cost of care (Penprase, Brunetto, Dahmani, Forthoffer & Kapoor, 2015). In order to provide higher quality pain management,

The aim of the hospice nurse is to make our end-of-life patients as comfortable as possible and to alleviate their pain. Unfortunately, however, pain control is very poorly addressed. The purpose of our meeting is to conduct a focus group that will brainstorm on a quality improvement plan, and a way to develop and evaluate the elements of a program that will more effectively address the issue of pain control. This program will be conducted within the format of the five P model: (1) Purpose (the purpose of the project will be focused on), (2) Patients (the discussion will be patient-oriented), (3) Professionals (professionals will be involved), (4) Processes (there will be an organized process) and, (5) Patterns (discussion will be on detected patterns).

(2009) evaluate the effects of a scheduled quiet time in acute care settings by examining noise levels, as well as sleep and resting behaviors. The study examines satisfaction levels among the staff, patients, and visitors in two Australian orthopedic units with the final sample size consisting of 299 patients. The interventions included in the trial were a scheduled, two-hour quiet time, restriction of visitors during this period, decreased staff interruptions such as patient care, reduction in the overall unit environment (i.e. lighting and noise), and pain relief and repositioning prior to quiet time. The results of this study found that the scheduled quiet time on the units can undoubtedly affect a reduction in noise levels and therefore, improved patient sleep patterns. The overall response from the surveys that were given to patients, visitors, and staff was that a scheduled quiet time would be a positively perceived intervention with therapeutic benefits. The weakness of the study includes the limitation that was due to the limited sample size and low response rates from the sleep scales and

The patients’ comments support the score of HCAHPS. Out of 75 negative comments, 33 of them address the issue of noisiness while only 1 out of 17 positive comments support the statement that area around the room is quiet at night. Therefore, it is evident that the HCAHPS claim on why Herzog Memorial Hospital has low satisfaction is valid.

When admitted to a hospital patients may feel they have little control over their situation and the surrounding environment. Using a call bell to meet their needs is perhaps one of a few things that gives patients a feeling that they still have some control. The title of the article Dance of the Call Bells: Using Ethnography to Evaluate Patient Satisfaction with Quality of Care, suggests that the key phenomenon of the study was the evaluation of patients’ satisfaction with quality of care they received in terms of their experience in the use of call bells (Deitrick, Bokovoy, Glenn, & Panik, 2006). The title did not describe the population, group or community under study, other than stating that the population was “patients”. The title did not state that phenomenon was also looked at and analyzed through perspectives of family members and staff, nor did it mention that the study was done on a med-surgical unit.