Efficacy of a Noise Reduction Program, Sound Pressures in the Operating Theatre, Surgical Complications
Conditions
Keywords
Reduction of noise pollution, Specifically enforced workplace rules, Stress, Sound Ears (TM), Error
Brief summary
Aim of Study: Adverse effects from noise pollution in operation theatres have been throughly demonstrated. We assessed the impact of a noise reduction program in paediatric surgery. Methods: A prospective controlled study on 156 operations performed by 16 surgeons was conducted. The sound levels before and after a noise reduction program based on education, rules and technical devices (Sound Ear tm) were assessed. Endpoints were spatially resolved sound levels matched by the surgeon's biometric (saliva cortisol, electrodermal activity) and behavioural stress responses (questionnaires). These were correlated with mission protocols and NoiSeQ for individual noise sensitivity.
Detailed description
We recorded median noise levels in the control vs. interventional group including the count of peak events with different tresholds. Three phases were conducted: 1. Reference group/phase I 2. Control group/phase II The full data set was recorded by a research clerk present in theatre however all staff were left unaware of the study purpose 3. Intervention group/phase III. The intervention consisted of a panel of work rules including mainly communication regulations (only conversations concerning the current case were allowed, no in and out during surgery, mobile phone ban etc.. Measures were backed by intervention conferences, posters and pictograms. . A wear off-effect was sought after . Biometrically, we analyzed the surgeon's pre- to postoperative rise in cortisol and the proportion of the surgeon's electrodermal potentials of \>15µS indicating severe stress. Intra-team communication, a decrease in disturbing conversations and sudden noise peaks were investigated and correlated with the individual noise sensitivity determined by the noise Q questionnaire.
Interventions
BEHAVIORALNoise reduction work place rules
Information conferences for all theatre staff (100%)on the detrimal effects of high noise levels in the operating theatre. Issue of workplace rules on handouts and poster on theatre doors: Ban of all mobile phones from theatre. Only conversations about the ongoing case are allowed. No restocking etc. during an operation and no work in this operating room concerning other patients (e.g. later on the list). Turnig of of unnecessary suckers, warming devices etc. . No in and out during the procedure. Technical: Sound Ears (TM, Sound Ear A.S. Copenhagen, Denmark) taped to all 4 Walls. Optical Telephones.
BEHAVIORALPresence of an examiner in the concerned theatre
Research Clerk present in theatre, writes on note pad.
Sponsors
University of Zurich
Technische Universität Dresden
Hannover Medical School
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
No minimum to 16 Years
Healthy volunteers
Yes
Inclusion criteria
* all operations of our tertiary referral center practice of the regular day programme involving children from preterm babies up to children of 16 years of age including emergencies at regular hours with a duration of \> 20 mins and \< 5 hours
Exclusion criteria
* After hour emergency surgery * Pediatric surgery cardiac cases * surgeries \<20 mins/\>5hrs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Noise level (dB(A)) in the operation room at the surgeon's place | continous during operation | noise levels are sampled simultaneously at 4 point (surgeon, nurses 1+2 and anestesiology workplace |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Surgeons intraoperative biometric and psychometric stress response | before, during and after operations | Surgeons Cortisol Levels and Electrodermal activity are measured as he/she is submitted to questionnaires. |
Countries
Germany
Outcome results
None listed