Noise reduction interventions in intensive care units: a systematic review

Abstract

Objectives: This systematic review aimed to examine the impact of noise reduction interventions on objectively measured noise levels, as well as associated clinical and perceptual outcomes for patients and healthcare professionals (HCPs) in intensive care units (ICUs). Methods: A systematic search of six electronic databases (PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, and Scopus) was conducted for studies published between January 2015 and December 2024. The review followed the Cochrane Handbook for Systematic Reviews and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines, and eligible studies were independently evaluated for quality assessment. Results: Of the screened publications, 12 met the inclusion criteria, including randomized controlled trials (RCTs) (n = 2) and quasi-experimental studies (n = 10). Various interventions have been implemented to mitigate ICU noise, which are classified into three categories: patient-directed interventions (e.g., earplugs), environmental modifications (e.g., soundproofing), HCP-oriented interventions (e.g., education, behavioral changes), and multicomponent interventions. The intervention period ranged from less than one day to four months. Outcome variables included noise level, sleep quality, physiological response, and HCP perception. Conclusions: ICU noise reduction interventions showed variable effectiveness, with multi-component approaches to address multiple noise sources. While interventions reduced noise levels and improved patient outcomes, noise levels often remained above the World Health Organization (WHO) standards. Evaluations of effectiveness have primarily been short-term, limiting analysis of sustained effects. To create a more conducive ICU environment for both patients and HCPs, future studies should focus on long-term effectiveness and include well-designed RCTs to strengthen the evidence base for noise management. Implications for clinical practice: Implementing noise reduction interventions, including HCP education, environmental modifications, and multi-component approaches, can improve ICU patient care and HCP well-being. Healthcare organizations should prioritize sustainable noise management strategies and conduct ongoing monitoring to ensure long-term effectiveness in ICUs.