SHHH! It`s Quiet Time at Stanford Hospital & Clinics

STANFORD, Calif.--(Business Wire)--
In the medical nursing unit of Stanford Hospital & Clinics, the culprit turned
out to be linen supply closet doors. Designed to close ever so quietly, they
were actually banging shut at night - keeping patients awake.

To the rescue came the Night Shift Noise Reduction Project, armed with SHHH
(Silent Hospitals Help Healing) signs. Instead of stuffing towels around the
doors to deaden the noise, the door signs urged nurses to call the General
Services Response Center to adjust the door-closing mechanisms. Also helpful:
unload supplies quietly at night, and be sure to keep your voices soft.

So, are patients now sleeping more soundly on the D-ground unit? "We won`t see
data until June" when patient survey results come in for the pilot period, said
Chuck Pitkofsky, RN, MSN, a member of the Noise Reduction team. "But
anecdotally, nurse managers are telling us they feel it`s quieter."

When Pitkofsky, Jodi Blanchard, Dan Polcyn, Buffie Stark, Carlos Villalva and
Carol Walovich were tapped last September to form a team and pick a project for
the SHC Leadership Academy, they decided to go on an investigative mission -
"playing detective, to figure out the sources of noise," as Pitkofsky put it.
Four nursing units had scored poorly on the Picker survey, a national
patient-satisfaction instrument that is mailed to patients after they are
discharged. Responses to a question asking about night shift noise levels had
drawn consistently poor numbers in those units.

The Noise Reduction team was expanded to include the nurse managers from the
four units. Nighttime visits to those units with a decibel meter in hand
confirmed that the causes of noise at the hospital were legion. Service carts
rattled over threshold strips, HVAC units wheezed, water pipes burped,
helicopters landed and took off, telephones rang, voices rose at nursing
stations. Not to mention the endless beeps and bongs emanating from monitors,
keypad codes and IV alarms.

"The alarms can`t be turned off, and the noise can escalate from there," said
Myra Lang, RN, MS, CCRN, patient care manager of unit B2 for intermediate
cardiac care. "People talk more loudly to be heard over the alarms, and when a
phone rings, you have to talk over that."

Lang herself has been a patient at Stanford Hospital twice in recent years, and
she brought a singular perspective to the questions asked by the Noise Reduction
team. While she said she felt more relaxed with her door open and hearing the
noise of the unit, "I expect noise, I live with it every day."

The Noise Reduction team looked at the kinds of noises they realistically could
shush, and decided on some immediate "interventions." First came signage. SHHH
posters were hung at nursing stations and at the doors to patient units, urging
quiet with a stylized finger on cartoon-strip lips. The team also purchased two
"SoundEars," LED displays in the shape of a human ear that light up - green,
yellow or red - when noise thresholds are crossed. The "ears" were rotated among
the four pilot units, with "a little module that sat on top, continuously
monitoring the noise for a week," Pitkofsky said.

Pitkofsky`s own nursing unit sits above a first-floor construction project. In
the early days of the project he went downstairs to the site to check out
workers` earplugs. The Noise Reduction team promptly ordered the same earplugs
for hospital patients - bright orange foam plugs with a noise-reduction rating
of 33.

Another intervention came from nurses` requests for the kind of pulse-oximeter
probes that routinely are used in intensive care units to monitor oxygen levels
in a patient`s blood. The ICU probes are more expensive but also stay on
patients` fingers better, thereby avoiding the false alarms that sound if the
probes inadvertently slide off.

Finally, each nursing unit was encouraged to appoint a "noise champion" to be
responsible for customizing noise reduction strategies on his or her floor.
Suggested bedtime routine as of 10 p.m.: dim hall lights, move nursing
conversations behind closed doors, close patient room doors if possible and keep
hallway conversations to a minimum.

Although the pilot project ended in April, Pitkofsky said a patient survey the
team developed to detect sources of noise still is being distributed biweekly in
a number of nursing units. "And our recommendation would be to continue with the
survey and the noise reduction strategies, which we hope to roll out to the rest
of the hospital in the near future," he said.

About Stanford Hospital & Clinics

Stanford Hospital & Clinics is known worldwide for advanced treatment of complex
disorders in areas such as cardiovascular care, cancer treatment, neurosciences,
surgery, and organ transplants. Consistently ranked among the top institutions
in the U.S. News & World Report annual list of "America`s Best Hospitals,"
Stanford Hospital & Clinics is internationally recognized for translating
medical breakthroughs into the care of patients. It is part of the Stanford
University Medical Center, along with the Stanford University School of Medicine
and Lucile Packard Children`s Hospital at Stanford. For more information, visit
http://stanfordmedicine.org.

Stanford Hospital & Clinics
Media:
Liat Kobza, 650-723-1462
lkobza@stanfordmed.org
Writer:
Diane Rogers, 650-723-3900
donut@stanford.edu

Copyright Business Wire 2009