Sound cultures of critical care

Marije Schokkin

Marije aimed to reduce the amount of noise in an intensive care unit (ICU), while taking into account the sound cultures, values and practices that currently exist.

In an ICU, patients are monitored and supported around the clock by medical equipment and a team of intensivists, nurses and other medical staff. The audible alarms from the equipment, as well as people talking and other incidental noise, made the ICU an acoustically hostile environment in which to work and heal. Marije therefore focused on reducing the excessive sound levels in an intensive care unit, taking into account the sound cultures.

The process of this dissertation started with a literature review on ICU sound culture. A research design was then formulated based on a qualitative, inductive and exploratory case study with a field research method based on context mapping. The field research, consisting of observations and interviews, was conducted in two Dutch ICUs, and a total of 14 nurses were interviewed. After the field research and data analysis, the results were discussed with the ICU managers and nurses, resulting in three core values and a concept.

Marije designed a campaign to establish a ‘collectivist sound culture’ in the ICUs, in order to reduce the overall sound level in the ICU and improve the well-being of both patients and nurses. The campaign is based on achieving four sub-objectives: 1) to provoke nurses into an initial small discussion about sound; 2) to support nurses in an in-depth discussion about their sound-producing behaviours and sound coping mechanisms; 3) to support nurses in a brainstorming session about possible solutions; and 4) to show the ICU management team which sub-goals to achieve and how to get there.

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