Hospital noise may have once been considered a simplenuisance, but today, studies show that loud hospital rooms impair the healing process. Phoenix Children’s Hospital measured decibel levels in its neonatal intensive care unit (NICU) and found that the level of everyday background noise was beginning to affect hearing for some of the hospital’s premature infants. Here, the Arizona hospital shares lessons learned for reducing noise levels for patients.


Work to eliminate the use of overhead pages to contact physicians or staff. Researchers have found that electronic sounds, such as telephones and alarms, are generally more disruptive to sleeping patients than human voices, regardless of how loud the sound. Mobile communication technologies—such as hands-free, wireless badges, and phones—allow clinicians to continue to care for patients as they receive status updates. These technologies also enable physicians and nurses to call other staff members and departments using intuitive voice commands. The level of noise created by use of these technologies is less disruptive for patients than the sound of overhead pages—and the technologies enable physicians and nurses to spend more time at the bedside.

Consider rubber flooring rather than tile in patient-care areas. Rubber flooring provides a cushion for carts being wheeled into rooms or down hallways and absorbs the noise of foot traffic. The softer surface of rubber flooring also limits the potential for noise to bounce around the room, providing an enhanced acoustic experience for patients.

Configure alarms so that they do not buzz at the patient’s bedside. Alarms should communicate only with the nurse or physician responsible for that patient. Text messages and voice alarms are two effective means for ensuring alarms are received only by those caring for patients. At Phoenix Children’s Hospital, integration of
wireless communications technology with the hospital’s nurse call and patient monitoring systems led to the elimination of alarms at infants’ bedsides in the NICU.

Look for ways to reduce the audible impact of hospital activity on patients through patient room design. For example, Phoenix Children’s Hospital at one time experimented with walling off portions of its NICU to decrease noise. The hospital ultimately redesigned one of its NICUs, located at another facility, to establish private patient rooms with soft lighting. Noise-reducing ceiling tiles also support a quieter environment. Today, Phoenix Children’s Hospital has one of the lowest infant mortality rates in the country. Now, noise reduction efforts are being replicated on every floor of the hospital.

Involve staff in reducing noise, particularly during shift changes. Staff should be encouraged to make sure they address only their intended listeners. All staff should feel empowered to politely ask others to lower their voices when conversations are becoming too loud. 

Deb Green, RN, is nurse manager, cardiovascular intensive care unit, Phoenix Children’s Hospital, Phoenix(

Brent Lang is president and COO, Vocera Communications,San Jose, Calif. (

Publication Date: Monday, April 01, 2013

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