Noise in Operating Room and Its Impact on Nurses: A Mixed-Methods Study of Noise, Perceptual Strain and Intervention...

To assess the acoustic environment of operating rooms (ORs) and its impact on nurses' perceptions in three surgical departments in a general hospital.

A mixed-methods study.

This study integrated sound level measurements, structured behavioural observations and a cross-sectional questionnaire survey. Acoustic data were collected during 41 surgeries in orthopaedics, general surgery and obstetrics-gynaecology. Observations identified typical noise events, and a validated questionnaire was used to assess perceived noisiness, communication and work efficiency interference, annoyance and the importance of a quiet environment.

Average noise levels in ORs exceed safety recommendations. The highest noise intensities occurred in the preoperative stage, primarily due to anthropogenic sources such as conversation, door movement and instrument collisions. Mid-frequency noise is dominant and overlaps with speech frequencies. Nurses identified conversation as the most frequent and disturbing noise source. Greater years of experience correlated with higher perceived noisiness, communication interference and annoyance.

Operating room noise affects nurses' communication, work efficiency and psychological comfort. As clinical experience increases, perceived cognitive load also rises. Anthropogenic noise sources are a major disruptive factor in a healthy OR environment and should be addressed through targeted interventions.

Noise mitigation should combine behavioural management, acoustic design and spatial optimisation to enhance nursing well-being and performance.

The study examined the impact of excessive OR noise on nurses' work performance and subjective well-being. OR noise exceeded safe thresholds, with conversation identified as the dominant and most disturbing source, particularly during preoperative phases. The findings inform OR design, management and training practices in surgical environments globally, with benefits for nursing staff.

This study followed STROBE guidelines.

No patient or public contribution.

Chinese Clinical Trial Registry (ChiCTR): ChiCTR2000038787.