QUIETNESS AT NIGHT
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Lehigh Valley Health Network LVHN Scholarly Works Patient Care Services / Nursing QUIETNESS AT NIGHT Valerie Mcmenamin ADN, RN Lehigh Valley Health Network, [email protected] Jannah Mae Solanoy BSN, RN Lehigh Valley Health Network, [email protected] Alexandra Nader BSN, RN Lehigh Valley Health Network Follow this and additional works at: hps://scholarlyworks.lvhn.org/patient-care-services-nursing is Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by an authorized administrator. For more information, please contact [email protected]. Published In/Presented At Mcmenamin, V. Solanoy, J. Nader, A. (2018, October 8). QUIETNESS AT NIGHT. Poster Presented at: LVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA.
Transcript of QUIETNESS AT NIGHT
Lehigh Valley Health NetworkLVHN Scholarly Works
Patient Care Services / Nursing
QUIETNESS AT NIGHTValerie Mcmenamin ADN, RNLehigh Valley Health Network, [email protected]
Jannah Mae Solanoy BSN, RNLehigh Valley Health Network, [email protected]
Alexandra Nader BSN, RNLehigh Valley Health Network
Follow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursing
This Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact [email protected].
Published In/Presented AtMcmenamin, V. Solanoy, J. Nader, A. (2018, October 8). QUIETNESS AT NIGHT. Poster Presented at: LVHN Vizient/AACN NurseResidency Program Graduation, Lehigh Valley Health Network, Allentown, PA.
© 2014 Lehigh Valley Health Network
Lehigh Valley Health Network, Allentown, Pennsylvania
QUIETNESS AT NIGHT
• On the 6C Medical-Surgical unit, will the implementation of theYacker Tracker raise clinical staff awareness of noise levels leadingto an increase of HCAHPS scores surrounding quietness at night?
• P: 6C Medical Surgical Unit• I: implementation of Yacker Tracker and raising staff awareness of
noise level reduction.• C: HCAHPS scores before and after implementation of the Yacker
Tracker.• O: Clinical staff will have increased awareness of noise levels at
night and HCAHPS scores will improve.
• The World Health Organization recommends that average patientroom noise levels remain around 30 decibels. Accordingto Medscape Medical News, the recommended maximum noise levelis 40 decibels. (The Daily Briefing, 2012)
• Noise has several negative physiologic effects on patients; increaseHR, increase BP, delay wound healing, impair immune function anddelay weight gain. Health care staff is also adversely affected.(Cranmer & Davenport, 2013)
• The “Yacker Tracker” serves as a constant visual reminder that noisereduction is important. (Ventura et al., 2015)
• Yacker Tracker increases awareness by staff of noise levels.Patients’ perceptions of noise levels had improved, with no poorratings and an increased number of fair, good, and very good ratingsbased on the surveys post-implementation of the project. (Connor &Ortiz, 2009)
• There was a decrease in noise level after the introduction of YackerTracker in a mental health ward for older adult patients with severedementia. (Brown et al., 2016)
• There was a significant decrease in noise before and afterimplementation of a quality improvement project in a pediatric unit inan acute care hospital where in they used a noise detector machine.(Soubra et al., 2018)
• Accuracy of Yacker Tracker device– Significant difference noticed in amount of red lights scored on different
nights.• Staff awareness of intervention
– Limited staff informed about the Yacker Tracker trial prior to implementation• Changes in Hospital Environment
– Amount of alarms, conversation level, patient population, occurring events
Have clinical staff take a pre-intervention survey measuring awarenessand compliance with promoting quietness at night.
Implement Yacker Tracker device on the unit during hours 2100-0630. Collect Yacker Tracker data regularly and determine the number of times
the Yacker Tracker turns red reduces. Collect data and compare previous HCAHPS scores to post-Yacker
Tracker HCAHP scores Reeducate staff on the benefits of quiet times Place reminders on unit to reinforce “Quiet Time” Encourage to continue using the quiet at night
kit (such as headphones, earplugs) Have clinical staff take post-intervention survey
6%
20%
27%27%
20%
How Often Staff Offers Earplugs to Patients
NeverRarelySometimesOftenAlways
Valerie McMenamin, ADN, RN Jannah Mae Solanoy, BSN, RN Alexandra Nader, BSN, RN
PICO(T) QUESTION
METHODS
EVIDENCE
LIMITATIONS
YACKER TRACKER DATA
REFERENCESJuliette Brown et al. (2016). Low stimulus environments: reducing noise levels in continuingcare. BMJ Quality Improvement ReportsAlison Connor, RN, BSN & Elizabeth Ortiz, RN, (2009). Staff Solutions for Noise Reduction inthe Workplace. The Permanente Journal Vol 13 No 4Cranmer, K. & Davenport L. (2013). Quiet time in a pediatric medical/surgical setting. Journalof Pediatric Nursing Volume 28, Issue 4, Pages 400–405The Daily Briefing. January 2012LVHN inpatient HCAHPSSoubra, Maher et al. (Mar/Apr 2018). Effect Of A Quality Improvement Project To ReduceNoise In A Pediatric Unit. MCN: The American Journal of Maternal Child NursingVentura M. et al. (2015). A Quiet environment is a healing environment. Journal of Perianesthesia Nursing. Volume 30 Issue No. 4
BACKGROUND
Quietness at night was identified as a component lowering HCAHPSscores on the 6C medical-surgical unit. The group decided to focus oninterventions to increase HCAHPS scores for quietness at night.
SURVEY DATA PRE AND POST INTERVENTION
0%0%
27%
53%
20%
How Often Staff Closes Doors to Reduce Noise
NeverRarelySometimesOftenAlways
050
100150200250300350400
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20Night Frequency of red lights detected
The accuracy of the Yacker Tracker was an issue during theimplementation of this project. The unit’s HCAHPS scores forquietness at night had little improvement during the project. TheYacker Tracker, however was a great tool to help raise awareness ofnoise levels on the unit.
The team’s recommendations are: to try another noise monitoringdevice; to strictly monitor noise throughout the unit and promptlyaddress it; to be compliant on the Quietness at Night initiative; and toinvolve all members of the unit in the improvement effort.
HCAHPS SCORES BEFORE AND AFTER IMPLEMENTATION OF QUIET INITIATIVES
CONCLUSIONS/RECOMMENDATIONS
38.1
25
36.4
44.446.7
42.9
31.836.8
05
101520253035404550
Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18
Comparison of HCAHPS scores Pre and Post Implementation of Quiet Initiatives
Before After
0%
10%
30%
40%
20%
Staff’s Overall Perception of Unit’s Noise Level
Very SoftSoftNeutralLoudVery Loud
Post intervention:
Pre intervention:
0%
5%
60%20%
10%
Staff’s Overall Perception of Unit’s Noise Level
Very SoftSoftNeutralLoudVery Loud
0%
10%
27%
40%
30%
How Often Staff Offers Earplugs to Patients
NeverRarelySometimesOftenAlways
0% 0%
15%
60%
25%
How Often Staff Closes Doors to Reduce Noise
NeverRarelySometimesOftenAlways
Quiet at Night Kit
