Background and importance: Noise is a contributing factor to mis-communication, poor sleep patterns and stress in healthcare. There has been little research on noise in the Emergency Department (ED). Objective(s) (1) To identify the noise levels experienced by staff and patients in different areas of an emergency department over the 24 hour cycle, (2) to examine the impact of cubicle doors on the background noise experienced by the patient, and (3) to assess the impact of monitor alarms on staff and patient noise levels. Design Observational study. Setting A large urban teaching hospital Emergency Department. Measures and analysis Using a standard protocol monitoring of staff and patient experience of noise was carried out in 3 areas of the ED (a resuscitation room, an area of patient cubicles with solid doors and and an area of patient cubicles with curtains). The overall distributions of noise levels in each area were described and circadian variation plotted. The proportion of time that background noise was above key cutoff values known to impair communication was calculated (45dB and 65dB). Non-parametric methods were used to compare: (1) a patient cubicle with curtains compared to a solid door, (2) having the door open or closed, and (3) staff and patient exposure a monitor alarm. Main results Noise was greater than 45dB for staff between 76% and 96% of the time (30% to 100% for patients). There was little difference across the 24hr cycle. A door decreased the noise experienced by patients, but only if left closed. In the resuscitation rooms monitor alarms were much louder for patients than for staff. Conclusion Noise levels likely to impair communication are present in the ED for most of the time. Staff awareness and improved design of both buildings and equipment might mitigate this negative acoustic environment.

中文翻译：

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急诊科的背景噪音：从工作人员和患者角度进行的观察性研究

背景和重要性：噪音是导致沟通不畅、睡眠模式不佳和医疗保健压力的一个因素。急诊科 (ED) 对噪音的研究很少。目标 (1) 确定急诊科不同区域的工作人员和患者在 24 小时周期内经历的噪音水平，(2) 检查隔间门对患者经历的背景噪音的影响，以及(3) 评估监护仪警报对工作人员和患者噪音水平的影响。设计观察研究。设置大型城市教学医院急诊科。措施和分析 在 ED 的 3 个区域（复苏室、一个有实心门的病人隔间区域和一个有窗帘的病人隔间区域）。描述了每个区域的噪声水平的总体分布，并绘制了昼夜变化图。计算了背景噪声高于已知会损害通信的关键截止值的时间比例（45dB 和 65dB）。非参数方法用于比较：(1) 带窗帘的病房与实心门的比较，(2) 门打开或关闭，以及 (3) 工作人员和患者暴露监视器警报。主要结果 工作人员在 76% 到 96% 的时间（患者为 30% 到 100%）的噪声大于 45dB。整个 24 小时周期几乎没有差异。一扇门减少了患者所感受到的噪音，但只有在关闭的情况下。在复苏室，监护仪警报对病人来说比对工作人员响亮得多。结论 ED 中大部分时间都存在可能影响沟通的噪音水平。员工意识和改进的建筑物和设备设计可能会减轻这种负面的声学环境。