Page 26 - Fall 2008

care unit.
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ry cues to attend to patients.
with similar patient acuity levels but differing layout and construction are being studied. Preliminary noise measure- ments and staff qualitative interviews have been conducted.
Results from the interviews show that effective auditory monitoring requires recognition, localization, and immediate reaction to critical sounds to improve patient safety, increase nurse work efficiency, and reduce nurse burnout. Critically important sounds that nurses use in accomplishing their tasks have been identified as key auditory cues including patient bodily sounds, threatening/unusual sounds, help calls from patients and other caregivers, and sounds from medical monitoring equipment.
In on-going phases, systematic mapping and documen- tation of auditory tasks is being used to define metrics for architectural enclosures that are pertinent to auditory con- nectivity. This approach to investigating the soundscape is crucial in order to retain the integrity of auditory cues while simultaneously reducing unwanted sounds.
Acoustical remodel of a burn acute care unit
This project, led by Howard Pelton, examined the various challenges faced in the acoustical remodeling of a burn acute
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It focused on a debridement treatment facility where burn patients undergo daily procedures. Debridement involves the use of water and/or surgical instruments to remove dead tissue. Debridement, along with the care team’s ability to keep the wounds clean and infection free, is a matter
Two ICU hospital settings
of life and death. Thus, maintaining an absolutely sterile and cleanable environment is vital and presents challenges in selecting acoustical absorption. Additionally, the debridement procedure is extremely painful for patients and loud distress sounds, including screams, are common. The existing facility consisted of hard surfaces with privacy curtains providing the only separation between the individual debridement stations. Sound isolation was also inadequate between the debridement facility and the rest of the ward. Patient distress sounds could clearly be heard throughout the ward creating a great deal of anxiety for patients—particularly for those awaiting their turn for treatment.
The remodeled facility was designed to have the ameni- ties of spa-like finishes to provide a more calming space for patients and staff. The unit was designed for enhanced sound isolation and included high sound transmission loss (STC) walls and doors. Cleanable absorptive treatments were select- ed for ceilings and walls to meet high sanitary standards. Figure 2 provides a view of the acoustical ceiling tiles and a wall mounted absorptive panel in the interior of a debride- ment treatment room.
Sound data was collected in the original facility during debridement treatment sessions to design appropriate sound isolation and overall acoustical design goals for the remodel. Leq and centile (Ln) sound pressure levels were measured to gauge the background sound levels and patient distress vocalization levels. L1 values (or sound pressure level exceed- ed 1% of the measurement time) were measured for typical
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Evaluating the Hospital Soundscape 25
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