Noise reduction interventions in intensive care units: a systematic review

Area of Science:

• Healthcare Management
• Environmental Health
• Critical Care Medicine

Background:

• Intensive care units (ICUs) are inherently noisy environments, negatively impacting patient recovery and healthcare professional (HCP) well-being.
• Elevated noise levels in ICUs are linked to adverse patient outcomes, including sleep disturbances and increased physiological stress.
• Effective noise management strategies are crucial for optimizing the ICU environment.

Purpose of the Study:

• To systematically review the impact of noise reduction interventions on objectively measured noise levels in ICUs.
• To evaluate the clinical and perceptual outcomes for patients and healthcare professionals (HCPs) associated with these interventions.
• To synthesize evidence on the effectiveness of various noise mitigation strategies in the ICU setting.

Main Methods:

• A systematic search of six major electronic databases was performed for studies published between January 2015 and December 2024.
• The review adhered to Cochrane Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Included studies were assessed for quality, encompassing randomized controlled trials (RCTs) and quasi-experimental designs.

Main Results:

• Twelve studies met the inclusion criteria, employing diverse interventions: patient-directed (earplugs), environmental modifications (soundproofing), HCP-oriented (education), and multi-component approaches.
• Interventions demonstrated variable effectiveness in reducing noise levels and improving patient outcomes like sleep quality.
• Despite reductions, noise levels frequently remained above World Health Organization (WHO) recommendations, and most evaluations were short-term.

Conclusions:

• Noise reduction interventions in ICUs yield varied effectiveness, with multi-component strategies showing promise for addressing multiple noise sources.
• While some interventions improve patient care and HCP well-being, sustained noise reduction below WHO standards requires further investigation.
• Future research should prioritize long-term effectiveness studies and robust RCTs to establish evidence-based noise management protocols for ICUs.