Effect of Implementing a Noise Reduction Bundle on Critical Care Nurses' Knowledge and Practice in Adult ICU

Excessive noise exposure in intensive care units (ICUs) remains a critical issue that adversely affects both healthcare professionals and patients. Prolonged and unnecessary noise contributes to psychological stress, sleep disturbance and physiological alterations, ultimately delaying patient recovery and increasing staff fatigue.

This Study Aimed to Assess the Effect of Implementing a Structured Noise Reduction Bundle on Critical Care Nurses' Knowledge and Practice in an Adult ICU in Egypt.

A quasi-experimental pre-post research design was employed in a single adult ICU characterised by an open-unit layout, which may influence ambient noise levels. Data were collected using four instruments: (1) a questionnaire assessing nurses' socio-demographic characteristics and knowledge regarding the noise reduction bundle; (2) an observational checklist evaluating adherence to noise reduction bundle practices; and (3) objective noise level measurements within the ICU before and after intervention.

Implementation of the noise reduction bundle significantly improved ICU noise outcomes and enhanced nursing competencies. Post-intervention, mean knowledge scores increased from 20.3 to 25.6 (p < 0.001), with satisfactory knowledge rates rising from 15.6% to 81.3%. Practice scores improved from 42.9 to 60.3 (p < 0.001), with satisfactory practice rates increasing from 14.1% to 82.8%. These improvements were strongly correlated with a statistically significant reduction in average noise levels across all ICU shifts (p < 0.001), reflecting tangible environmental improvements.

Effective noise reduction in ICUs requires integrated bundle interventions, workflow modifications and behavioural changes in staff communication, which collectively foster a sustainable and quiet clinical environment conducive to patient recovery and staff well-being.

Future research should involve larger and more diverse populations to validate these findings, develop standardised noise control protocols and assess the long-term impact of continuous staff education programmes and integrate noise management strategies within institutional quality improvement frameworks.

Noise in intensive care units (ICUs) is a critical environmental stressor that affects both patients and healthcare professionals. Excessive noise disrupts patient sleep, delays recovery, increases stress and contributes to staff fatigue and communication errors. Implementing a structured noise reduction bundle provides a practical and evidence-based approach to minimise unnecessary sound exposure, enhance patient comfort and promote safer, more focused clinical environments. Strengthening ICU nurses' knowledge and adherence to noise reduction practices fosters a culture of awareness and accountability that supports high-quality, patient-centred care.