Hospital Reports – Reducing Noise Pollution in the Operating Room – Medela AG

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Reducing Noise Pollution in the Operating Room Noise Pollution in the Operating Room and How to Avoid It Noise Pollution: The Hidden Threat The Financial Cost of Noise Pollution in the Operating Theatre The Future of Noise Reduction Strategies

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What if there was a simple way to greatly reduce OR noise levels?

Medela Dominant Flex and the Medela Fluid Collection System contribute to less noise in the operating room.

Find out more about our systems at https://www.medelahealthcare.com/solutions/professional-vacuum-solution

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

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Reducing Noise Pollution in the Operating Room Noise Pollution in the Operating Room and How to Avoid It Noise Pollution: The Hidden Threat

Contents

The Financial Cost of Noise Pollution in the Operating Theatre The Future of Noise Reduction Strategies

Foreword

2

Tom Cropper, Editor

Noise Pollution in the Operating Room and How to Avoid It

3

Sponsored by

Medela AG Published by Global Business Media

The Impact of Noise Published by Global Business Media

Reducing Noise Pollution

Global Business Media Limited 62 The Street Ashtead Surrey KT21 1AT United Kingdom

Source of Noise Pollution

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Evolving Demand

Publisher Kevin Bell

Tom Cropper, Editor

Business Development Director Marie-Anne Brooks Editor Tom Cropper Senior Project Manager Steve Banks Advertising Executives Michael McCarthy Abigail Coombes Production Manager Paul Davies For further information visit: www.globalbusinessmedia.org The opinions and views expressed in the editorial content in this publication are those of the authors alone and do not necessarily represent the views of any organisation with which they may be associated.

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The Whisper Quiet Feature

Noise Pollution: The Hidden Threat

6

Impact of Noise Pollution Communication Problems Where the Noise Comes From

The Financial Cost of Noise Pollution 8 in the Operating Theatre

Jo Roth, Staff Writer

Lower Standards Staff Wellbeing The Financial Calculation

The Future of Noise Reduction Strategies

10

James Butler, Staff Writer

Growing Awareness Solving the Problem Quieter Equipment

References 12

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SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

Foreword H

ospitals take every care to ensure the safest

also cost money which health services can ill afford.

possible environment for staff and patients,

Errors in the operating room contribute to rising

but there is one area which is often overlooked

litigation which is putting the financial sustainability

- noise. In the modern operating threatre, noise

of health services at risk.

regularly exceeds recommended safe levels and puts staff and patients at risk.

For many reasons, therefore, noise pollution in the Operating Room should be treated as a major issue.

Our opening article comes from Medela Healthcare

In our final article, James Butler looks at some of the

who are leaders in the drive to produce quieter

latest noise reduction strategies which address the

equipment. They highlight how noise pollution has

problem, including staff education and ear protection.

become a serious health and safety hazard for

However, the biggest cause of serious noise pollution

surgeons, staff and patients.

is equipment. Addressing this issue with new, quieter,

Elsewhere in the Report, we look more deeply

devices will be crucial.

at the impact of noise pollution within the surgical

Technology is always moving forward. In the case of

environment. Increased noise adds to feelings of

noise pollution, it is both the cause and the solution of

anxiety and leaves medical staff feeling fatigued.

the problem. It is the reason why noise often exceeds

Worst of all, it creates distractions, making it difficult

safe levels, but it also holds the key to producing a

to communicate and increasing the risk of error.

quieter environment in the future.

The human impact is severe, but as Jo Roth discovers, the financial implications should not be underestimated. The biggest concern is obviously the risk to patient health, but Operating Room mistakes

Tom Cropper Editor

Tom Cropper has produced articles and reports on various aspects of global business over the past 15 years. He has also worked as a copywriter for some of the largest corporations in the world, including ANZ Bank, ING and KPMG.

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SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

Noise Pollution in the Operating Room and How to Avoid It Medela AG While hospitals take risk control seriously, there is one area they are overlooking.

As numerous studies now show, noise pollution should be seen as a serious safety issue.

“Unnecessary noise is the cruellest absence of care which can be inflicted either on sick or on well.”

So said Florence Nightingale in 1859 and, more than a century and a half later, it still holds true.

Noise levels are getting worse and they are causing stress, anxiety and might lead to mistakes.

Nowhere are these impacts being felt more directly than in the operating theatre where noise levels can exceed 100 decibelsi.

The Impact of Noise Technology has transformed the operating room (OR). Although it has made operations safer, it has also greatly increased noise levels.

Today, surgical staff are routinely exposed to levels of noise that far exceed officially recommended limits.

Studies find that noise pollution within the operating theatre can reach peaks of 130dBaii.

Recommended noise levels within hospitals should be 45dBa or less which means staff are regularly exposed to harmful levels of noiseiii.

While hospitals have made great strides with other areas of risk, such as infection control, this remains relatively overlooked. Even so, the impact can be profound, as various studies have found. A literature review from 2016 identifies a number of key problems caused by noise, includingiv: • Noise in the OR can lead to permanent psychological stress in staff.

• Distractions (e.g. background noise) have a negative impact on communication within the operating room among staff.

• All this noise also contributes to surgical errors and poor patient outcomes. An alarming 83% of healthcare staff say they believe noise pollution contributes to surgical error.

• 80% felt that noise harmed communication and 77% believed it harmed concentration.

Problems can also be caused by the type of noise pollution. A study from Carlos Rogero Degrandi Oliveira and Gilberto Walter Nogueira found that an unexpected noise or some noise coming from an unknown source could cause various reactions. “In temporary exposure,” states the report, “the body returns to normal, corresponding to the primary reaction. If the noise

source is maintained or alternated persistent changes may occurv.”

Aside from the human toll and the impact on patient health, surgical errors have a very real financial implication. They are likely to lead to longer stays in hospital. According to a study into surgical site infections and their link to noise pollution by Dholakia et al, the additional costs to patients is £243vi (in UK) and can also lead to compensation claims from patients or their families who have suffered the consequences of a surgical error.

The Medela Surgical Suction Pump Dominant Flex meets the demands of the modern OR as it is small, quiet and portable

Reducing Noise Pollution Addressing this problem, therefore, should be seen as an important priority by hospitals.

Noise reduction programs have the potential to reduce extra costs for e.g. postoperational surgeries significantly. They would minimise errors, lead to shorter hospital stays and improve the wellbeing of staff.

They can improve the quality of care being given while simultaneously reducing the strain on healthcare budgets.

This is, then, an issue. Hospitals have a duty to protect their patients and safeguard the health and wellbeing of staff. At the same time, budgets are stretched and they need to minimise spend on additional hospital care. Tackling noise pollution should therefore be seen as a high priority issue.

This starts by identifying where the noise is coming from.

Source of Noise Pollution According to the Oliveira study, the biggest source of noise pollution comes from medical devices such as monitors, anesthesia machines, ventilators, air conditioners, conversations and WWW.HOSPITALREPORTS.EU | 3

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

Change is coming!

Noise pollution, as well as infection control, are seen increasingly as an important safety issue. Hospitals can take measures to ensure they stay ahead of the trend

FIGURE 1 - THE INFOGRAFIC ABOVE SUMMARIZES THE HARMFULNESS OF NOISE POLLUTION IN OPERATIONG ROOMS *1) *2) Source: A.D. Padmakumar et al.,”Effect of noise on tasks in operating theatres”, 2017

what they describe as ‘procedure peculiarities’vii.

Machines and alarms can cause sudden spikes in noise levels, which hinder conversation, affect concentration and cause additional stress.

By designing equipment to produce less noise, therefore, it is possible to significantly reduce noise levels within the operating room. Less noise will mean: 4 | WWW.HOSPITALREPORTS.EU

3 Better concentration 3 Easier communication 3 Fewer errors

The Whisper Quiet Future At Medela, we have been addressing this issue with our Basic and Dominant Flex pumps, all of which are equipped with a powerful drive unit

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

that is whisper quiet. It is less than 40 decibels, which makes it up to four times quieter than comparable solutions.

In addition, it offers: •S uperior performance and faster suctioning power.

•P atented membrane regulator that creates fast vacuum build-up for instant suction.

•H ands-free operation thanks to an on/off foot switch.

• I t is designed to last a lifetime with a five-year warranty.

• I t is versatile in all forms. The high-vacuum pumps are available in rack, portable or mobile versions with a trolley.

•T he inner construction simplifies routine checks and can reduce costs.

Designed for hospitals, clinics and doctors’ practices, they represent the latest innovation in high performance vacuum solutions. They are quieter, smaller and more flexible than cumbersome and noisy wall mounted vacuums.

An independent vacuum avoids overflow into the wall systems and, instead, offers a smooth, consistent and reliable performance.

The Medela Surgical Suction Pump Dominant Flex meets the demands of the modern OR as it is small, quiet and portable. By cutting down on one of the loudest sources of noise in the OR it takes a great stride towards solving noise pollution issues. It reduces noise levels from equipment to below the recommended

thresholds for health and effective communication, making it easier and less stressful for staff to carry out their jobs. Equally, it reduces the sudden noise spikes, which come from the operation of surgical equipment.

Evolving Demand Attitudes are changing. Research points to the risks of noise pollution and guidance is being developed. Hospitals are implementing noise reduction programs across their operations. It is important that managers understand not only the risks but also all the available options in their drive to reduce noise.

Yes, education is important and, yes, there are many things which can be done to reduce unnecessary noise. Noise can be disturbing and lead to distraction, increasing stress and making it more difficult for surgical teams to communicate. Situations in the OR which cause distraction and stress might lead to surgical errors and - needless to say - this might put patients at risk and can lead to an increase of the costs of care.

At Medela, we have implemented (with our surgical pumps Basic and Dominant Flex) the gains that can be made: a four-fold decrease in noise pollution, simply by addressing the design of our equipment. Change is coming!

Noise pollution, as well as infection control, are increasingly seen as an important safety issue.

Hospitals can take measures now to ensure they stay ahead of the trend.

Attitudes are changing.

Research points to the risks of noise pollution and guidance is being developed

References: i

Evaluation of Noise in the Operating Theatre: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598129/#B9

iI

Effect of Noise Pollution on Staff (Padmakumar et al): https://www.ncbi.nlm.nih.gov/pubmed/27810115 iII

The Association of Noise and Surgical Site Infection: https://www.ncbi.nlm.nih.gov/pubmed/25737006

iv

Effect of Noise Pollution on Staff (Padmakumar et al): https://www.ncbi.nlm.nih.gov/pubmed/27810115

v

Occupational Exposure to Noise Pollution in Anesthesiology: http://www.scielo.br/scielo.php?pid=S0034-70942012000200011&script=sci_arttext&tlng=en

vi

The Association of Noise and Surgical Site Infection: https://www.ncbi.nlm.nih.gov/pubmed/25737006

vii

Occupational Exposure to Noise Pollution in Anesthesiology: http://www.scielo.br/scielo.php?pid=S0034-70942012000200011&script=sci_arttext&tlng=en

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SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

Noise Pollution: The Hidden Threat Tom Cropper, Editor It’s not as commonly discussed as it could be, but noise pollution in the operating room (OR) can harm the wellbeing of staff, make it more difficult to do their job and put patients at risk.

T

Miscommunication is one of the leading causes of error in the operating room.

The fact that noise levels make communication more difficult, said the report, meant that noise should be seen as a significant risk factor

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HE OPERATING theatre is one of the mos t high - pres sure working environments imaginable. The stakes are high, communication is vital and every task requires 100% concentration. Imagine, then, the impact that a sudden loud noise would have.

Unfortunately, this is the environment in which surgical staff regularly find themselves. However, although plenty of work has been done to adjust other environmental issues such as air quality, noise pollution has received relatively little attention, until now.

Impact of Noise Pollution Hospitals, and operating theatres in particular, have become extremely busy and noisy places.

From the seventies onwards, the introduction of technology saw noise within the operating theatre rise considerably. Today it routinely exceeds levels which are considered hazardous to health1.

A 2019 report into the impact of noise pollution in the operating theatre, found that it has a significant impact on medical staff. The study evaluated noise levels in the three areas of the operating theatre during all three shifts, before asking medical staff to complete a questionnaire.

59.2% of respondents described the workplace as noisy and 53.4% said it was disturbing.

The report found that a relatively high level of professional burnout has been proven in medical staff (75.7% high depersonalisation and 48.6% emotional exhaustion).

Nursing staff said they found the environment noisy with 37.1% saying it made them more irritable. 48.2% said they felt stressed and 72.2% experienced fatigue. Professional burnout among nurses was also high (59.3% high depersonalisation and 61.1% emotional exhaustion).

In conclusion, the report found that noise affected different people in different ways depending on their role and where they worked. It had a negative impact on wellbeing and is one factor contributing to professional burnout among surgical staff2.

Communication Problems Background noise in the OR can also make it more difficult for surgical staff to do their jobs.

A study published by the American College of Surgeons tested 15 surgeons with one to 30 years of operating experience in noise environments similar to the average OR. Their ability to understand speech was tested using the Speech in Noise Test Revised (SPIN-R) under four different conditions including quiet, filtered noise through surgical masks and background noise with and without music. They were tested while engaged in tasks and when task free.

The study identified a significant reduction in comprehension when questions were unpredictable with the presence of background noise. This, researchers said, was significant because unpredictable questions tend to be the ones which carry critical information.

Speaking at the time, the study’s co-author, Dr Matthew Bush said: “Our main goal is to increase awareness that operating room noise does affect communication and that we should foster the best environment in which we can communicate better3.”

Miscommunication is one of the leading causes of error in the operating room4. The fact that noise levels make communication more difficult, said the report, meant that noise should be seen as a significant risk factor.

Another study backs this up. According to a questionnaire sent to 50 UK hospitals, 83% of respondents felt that noise contributed to human error and more than half thought the operating theatre was the noisiest area in the operating suite5.

Where the Noise Comes From Noise comes from a number of sources, including staff, equipment and, in many cases, music. The study by the American College of Surgeons said that the presence of music hindered communication. However, over 70% of respondents to the UK hospital survey said they

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

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felt music did not contribute to errors. Indeed, most studies suggest music can significantly improve surgical performance6.

This leaves staff and equipment. As technology improved over the past few decades, the quantity of machines within the OR has also increased, with a subsequent impact on noise levels.

According to the publication Anaesthesiology, equipment-related noise levels during peak operating times can be as high as 120 decibels. At peak times, surgical noise could be more than 130 decibels and, during noisy procedures, levels could be more than 100 decibels for 40% of the time7.

Given that safe workplace noise levels are around 50 decibels and 140 decibels cause physical pain, noise should be seen as a significant health and wellbeing factor for both medical staff and patients.

Surgical teams can take measures to reduce noise levels, but the best way to have a major impact on noise pollution within the OR is to reduce the sound made by medical equipment.

Slowly, but surely, attitudes are changing and this is beginning to happen.

Manufacturers are bringing to market new equipment which offers reduced sound footprints.

For example, enhancements to the drive units can significantly reduce the noise made by devices.

If each piece of equipment can eliminate 50% of noise pollution, it would have a profound effect on the environment within the operating theatre.

The benefits could be felt by medical staff who could finally enjoy a more pleasant working environment, by patients who would be more comfortable and by surgeons who will have fewer distractions during extremely challenging and complicated procedures.

Miscommunication is one of the leading causes of error in the operating room

Given that safe workplace noise levels are around 50 decibels and 140 decibels cause physical pain, noise should be seen as a significant health and wellbeing factor for both medical staff and patients

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SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

The Financial Cost of Noise Pollution in the Operating Theatre Jo Roth, Staff Writer Noise pollution has a serious drain on healthcare resources. At a time when money is tight, addressing noise pollution is becoming increasingly important.

N Stressed professionals also make more mistakes. A study which used technology to measure the electrical activity of a surgeon’s heart during procedures found that a loud noise could trigger short term intervals of stress, which also increase the risk of a mistake by 66%

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OISE POLLUTION is a serious but underestimated problem in the healthcare sector. It is stressful for staff and patients; it impacts physical and mental health and can increase the risk of surgical error. By all important metrics, this is an issue which health services should be taking more seriously.

Even so, one thing always stands in the way: money. Budgets are stretched and almost every decision, no matter how important, will have to make a financial case. In this article we will attempt to analyse the fiscal impact of noise pollution.

Lower Standards The most serious claim is that noise pollution increases the risk of error. A literature review found that noise in the operating room hinders communication, affects concentration and makes it more difficult to perform complex tasks8.

The inevitable result, the review implies, is that the risk of error will be higher. Distracted surgeons, struggling to hear their colleagues are more likely to make mistakes, which has serious implications for patient safety and hospital finances.

First, let’s look at the very obvious threat to patient safety. Patients who suffer a surgical error are seven times more likely to die while hospitalised and are much more likely to be readmitted within three months9. Controlling noise pollution should be seen as part and parcel of a hospital’s duty of care towards its patients.

The financial impact comes from increased care requirements and possible legal action.

Mistakes lead to more serious and urgent interventions, longer hospital stays and more expensive care. If errors are serious, they will also expose the hospital to legal action. Figures suggest that negligence claims against the NHS have doubled in five years following a steep rise in delays. In total, 1,789 patients, or their bereaved families, received payments in 2017/18, a rise

from 1,406 cases in 2013/14. This equated to payments of £655 million, up from £327 million.10 Part of this rise comes from pressures on NHS services as well as a burgeoning claims market.

As a quick search on Google demonstrates, this is a healthy market full of participants, some more trustworthy than others. The noisier ORs become, the more likely it is that errors will happen and the more difficult it will be to reduce the cost of negligence claims.

Staff Wellbeing A secondary and slightly difficult to measure impact is staff wellbeing. As we saw in the first article, noise pollution contributes to mental health problems. The last few years have seen a surge in stress related illnesses among NHS staff. They are taking 100,000 more sick days than they did six years ago, according to figures from NHS Digital11.

In acute departments there has been a 35% rise in the number of sick days taken. The most common anecdotal reason given by professionals include staff shortages and an overwhelming workload. However, noise pollution also subtly increases stress and feelings of exhaustion in ways which are not always immediately apparent.

In the UK, employers must provide protective equipment for workers exposed to more than 85 decibels. Hearing checks are also required for workers regularly exposed to noise levels more than 85 decibels12.

An evaluation of noise pollution in ORs show that procedures regularly register noise levels of more than 90 decibels, significantly higher than recommended safe guidelines13. The literature review mentioned earlier suggested peak operational procedures could see noise levels as high as 130 decibels.

This noise increases stress levels for staff, which has multiple impacts. Firstly, it reduces the happiness and wellbeing of staff which

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

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leads to more time off and people leaving the profession. As a recent report found, stress and burnout are two of the leading causes for people leaving their jobs14.

Stressed professionals also make more mistakes. A study which used technology to measure the electrical activity of a surgeon’s heart during procedures found that a loud noise could trigger short term intervals of stress, which also increase the risk of a mistake by 66%15.

The Financial Calculation Noise, therefore, can be expensive. By investing in measures which reduce or eliminate noise pollution, hospitals will save money in the longer run. But the question remains: can they afford that investment?

The financial struggles of the health service have been well documented. Rising patient numbers, better technology and an aging population requiring long term and complex care, are putting health budgets under pressure. A lack of investment from successive governments has left health services across the world struggling to make ends meet.

A report in the Guardian found that hospitals are already struggling to afford new equipment16. This forces staff to use out of date equipment which reduces the quality of care. For example, because radiologists are using out of data scanners, health services can be forced to spend significant resources rescanning patients. Substandard equipment costs money in many different ways - It reduces performance, increases workload and, if it’s noisy, creates a stressful and uncomfortable operating environment.

This is a considerable and ongoing drain on resources. By addressing noise pollution, hospitals can make gains at multiple points. They can reduce the strain on medical professionals, improve care and reduce errors. To do this, they will have to look at the type of equipment they are using. Loud mechanical devices such as vacuum pumps can push noise levels inside the operating theatre well beyond healthy levels. Manufacturers are increasingly looking at solutions to reduce the noise their devices make. As we’ve seen in this article, this not only makes life more comfortable for surgical teams and patients, but also the people in the accounts department!

Noise, therefore, can be expensive. By investing in measures which reduce or eliminate noise pollution, hospitals will save money in the longer run

Substandard equipment costs money in many different ways - It reduces performance, increases workload and, if it’s noisy, creates a stressful and uncomfortable operating environment

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SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

The Future of Noise Reduction Strategies James Butler, Staff Writer Noise in the operating room frequently exceeds safe levels. The question now is: what can hospitals do about it?

W Research was sporadic

HEN CHOOSING equipment for the operating theatre, managers might focus on price, economy, performance or efficiency. However, going forward they will have to pay more attention to how much sound it makes. Noise pollution is a serious, yet until now unrecognised, hazard in the operating room (OR).

until a few years ago,

Growing Awareness

but the last few years

Awareness is finally beginning to build. Research was sporadic until a few years ago, but the last few years have witnessed a flurry of studies and literature reviews into the effectiveness of noise reduction strategies.

A 2014 study from Engelman et al assessed the impact of a noise reduction program in the operating theatre. Over the course of 156 operations, sound levels were measured after a noise reduction program. This program focused on education, rules and specific technical devices.

The biometric data of surgeons was taken before and after the noise reduction program while a questionnaire measured their behaviour.

Median noise levels in the intervention group were down by −3 ± 3 dB(A) (63 vs 59 dB(A), P < 0.001) with a grossly decreased number of peaks greater than 70 decibels. The study found that the spontaneous rise in noise during an operation equated to a lawnmower or a passing truck. However, specific measures could reduce the sound levels by 50%. This reduction led to fewer post-operative complications and responders exhibited marked improvements in their behavioural and biometric indicators17.

Surgeons with an above average sensitivity to noise experienced improved team communications, a decrease in sudden noise peaks and disturbed conversations. The intervention also reduced both the surgeons’ pre and post-operative rise in cortisol by approximately 20%. The surgeons’ electrodermal potentials of greater than 15 μS, indicating severe stress, fell by 60% (P > 0.05).

have witnessed a flurry of studies and literature reviews into the effectiveness of noise reduction strategies

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Solving the Problem Studies such as this have demonstrated the psychological and physical impacts of OR noise pollution. Acknowledging the problem, though, is one thing. Doing something about it is something else. Noise is an inevitable result of OR life whether through staff communication or equipment noise.

Strategies must be multi-layered, providing protection in some instances and mitigating noise production in others.

A report from the American College of Surgeons made the following recommendations to reduce noise levels and interruptions18.

• Create a no interruption zone, or sterile cockpit during critical phases of a procedure. This would prohibit telephone calls or non-essential conversations.

• Noise levels should be measured within the OR to provide evidence for the effectiveness of noise reduction strategies. Empirical data could be used to assess the success of interventions and provide real time information to the OR team about when noise levels exceed recommended maximums.

• Educate staff on the sources of noise and their impact on staff safety, as well as what can be done to mitigate the problem.

• Evaluate the physical environment and identify ways to reduce noise such as minimising the dropping of instruments into trays.

• Add simulation training to enhance focused attention skills in the presence of noise and distractions.

• Simulation training to improve noise reduction strategies.

•C onsider alternative equipment that produces less noise.

Quieter Equipment Any noise reduction strategy will require a blend of all these measures. However, it is the last point B where the largest gains can be made.

Staff can modulate their behaviour and practices, managers can eliminate external

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

© MEDELA

distractions, but equipment and machines will still produce sound.

Gradually, manufacturers are waking up to this new demand. As health services become more sensitive to the importance of noise pollution within the operating theatre, they are creating fresh demand for equipment which offers a solution.

Some of the latest devices are now beginning to draw on noise reduction features. Medela’s latest range of dominant Flex and Basic Suction Pumps, for example, are marketed as being ‘whisper quiet’. Conventional wall mounted models can produce noise levels of more than 100 decibels. This product, though, brings that down to less than 40 decibels. Combined with a more flexible and portable design, the device is configured around usability and comfort19.

Other approaches provide staff with more protection from noise. The challenge is to block unnecessary noise, while ensuring medical staff can communicate. One solution is the Silent Operating Theatre Optimisation System which uses multiple wireless headsets with incorporated wireless speakers to control the communication matrix. Trials have suggested positive feedback from surgical staff using the devices20.

Other studies have looked at the composition of walls. Sound absorbing materials have been

used to create a more harmonious atmosphere within the room. For example, in one case study a unique flash spun plexifilamentary film-fibril sheet was used to absorb noise. However, using sound proofing material runs into problems with infection control.

The impact of noise pollution, then, can be controlled within the OR setting in a number of ways. Staff can be educated, procedures changed and protective equipment can be used.

Without addressing the most serious cause of sudden peaks in noise, though, progress will be limited. Machines can produce sudden bursts of noise which far exceed recommended safe guidelines. Such noise is stressful, upsetting and distracting, but this needn’t be the case. As new products demonstrate, devices can be made to run more quietly without impacting performance or dramatically affecting the price.

Technology develops quickly. As attitudes change, demand shifts. In the future noise pollution may well become one of the first things managers consider when buying machines for the OR. One thing’s for sure. There is a concerted push to reduce noise polluting in theatres.

By doing so successfully, hospitals can save money, avoid mistakes and improve the mental health of some of the most important professionals within the healthcare system.

Gradually, manufacturers are waking up to this new demand. As health services become more sensitive to the importance of noise pollution within the operating theatre, they are creating fresh demand for equipment which offers a solution WWW.HOSPITALREPORTS.EU | 11

SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM

References: 1

Noise in the Operating Room:

https://www.healthdesign.org/chd/knowledge-repository/noise_operating_room%E2%80%94what_do_we_know_review_literature Assessment of Noise Pollution in the Operating Theatre:

2

https://www.researchgate.net/publication/331563464_ASSESSMENT_OF_NOISE_POLLUTION_IN_OPERATING_THEATRE Background noise in the operating theatre can impair surgical team comprehension:

3

https://www.sciencedaily.com/releases/2013/05/130510124558.htm Miscommunication: A Major Cause of Error:

4

https://www.kqed.org/stateofhealth/22697/miscommunication-a-major-cause-of-medical-error-study-shows Effect of Noise in the Operating Theatre: https://www.ncbi.nlm.nih.gov/pubmed/27810115

5 6

Music Improves Surgical Performance: https://www.classicfm.com/music-news/classical-music-in-operations-makes-surgery-faster/

7

Noise in the Operating Room: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=1921569

8

Noisy OR Linked to Communication Gaps:

https://www.mdedge.com/surgery/article/98123/general-surgery/noisy-or-linked-communication-gaps-surgical-site-infections 9

Surgical Errors on the Rise: https://www.hg.org/legal-articles/surgical-errors-on-the-rise-25594

10

NHS Negligence Pay-outs Double: https://www.telegraph.co.uk/news/2019/05/12/nhs-negligence-payouts-double-following-steep-rise-delays/

11

Huge Surge in Stress Related Illness in the NHS:

https://www.itv.com/news/2019-05-02/huge-surge-in-stress-related-illness-in-the-nhs-as-staff-report-growing-anxiety-over-underfunding-and-understaffing/

12

HSE Noise Regulations: https://www.hse.gov.uk/noise/regulations.htm

13

Evaluation of Noise Levels: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5598129/

14

NHS Staff Quitting Due to Burnout: https://www.theguardian.com/society/2019/jun/03/nhs-staff-quitting-due-to-burnout-and-bullying-report-says

15

Operating Room Pressures: Surgeons Under Stress Make More Mistakes:

https://www.healtheuropa.eu/operating-room-surgeons-under-stress/89512/ 16

Hospitals Struggling to Afford Equipment

https://www.theguardian.com/society/2018/may/22/hospitals-struggling-to-afford-new-equipment-after-nhs-budget-cuts 17

A Noise Reduction Program in the Paediatric Operation Theatre:

https://journals.lww.com/annalsofsurgery/Citation/2014/05000/A_Noise_Reduction_Program_in_a_Pediatric_Operation.28.aspx 18

Noise Pollution Can Affect Patients, Staff Safety: https://bulletin.facs.org/2017/10/noise-and-distractions-in-the-or-can-affect-patient-staff-safety/

19

Dominant Flex and Suction Pumps:

https://www.medelahealthcare.co.uk/solutions/professional-vacuum-solutions/surgical-airway-suction/dominant-flex-and-basic-suction-pumps 20

New Technical Solution to Minimise Noise Pollution: https://innovations.bmj.com/content/3/4/196

12 | WWW.HOSPITALREPORTS.EU

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