When It Comes to ICU Care, Silence Is Golden

When the lights are low, curtains drawn and conversations drop to whispers, it is "quiet time" on two University Campus intensive care units (ICU). Quiet time helps improve patient care and experience through noninterrupted sleep periods scheduled from 2 to 4 o'clock every morning and afternoon in 3ICU and the Pediatric Intensive Care Unit (PICU).

While medical care never stops and staff is constantly monitoring patients, scheduled tests and nonclinical activities are now coordinated around quiet time. This helps ensure patients are getting enough quality sleep while reducing confusion, dementia, agitation and other symptoms. "When staff ask each other to be quieter, it is not considered rude anymore," explained Elizabeth Colo, RN, nursing education specialist, 3ICU. "At 2 o'clock, sound levels go down a notch, bringing a calm to the unit."

Family response and staff experience are positive. "I expressed concerns with my peers about the noise levels in the PICU and was asked if it was something I wanted to work on," said Cheryl Hamel, RN. "Now, patients and families tell me how much they look forward to quiet time so they can rest."

Quiet time has motivated and united staff. "Our nurses took ownership of the process," said Cheryl Dunnington, RN, director of eICU operations. Added Joanne Nye, RN, 3ICU, "Management gave us the support to turn an idea into a new program that benefits patients and our work environment."

Efforts are underway to measure quiet time outcomes, including patient and family exit surveys, staff surveys, and noise and patient-length-of-stay studies. Noise-reduction efforts, such as sound proofing, built-in sound level meters and noise alert devices, are also being pursued.