南部某醫學中心急診加護病房噪音改善方案

Noise Reduction at an Emergency Intensive Care Unit of Medical Center in Southern Taiwan

護理主管常接到病患、家屬抱怨對加護病房內嘈雜聲感到不舒服、嚴重干擾睡眠與休養，工作人員有時在此吵雜的環境下，未聽到醫療儀器所發出的警訊聲，甚至發生情緒不穩或失控情形，故引發進行改善動機。本專案目的在降低南部某醫學中心加護病房噪音危害。經盤點、分析、測量噪音來源、產生原因、噪音量、及使用特性要因圖後，發現病室內之機械性噪音值最高達79.6分貝，經確立了噪音干擾問題及設立改善目標，並藉由13項改善措施，期望能降低病室音量。結果顯示：在諸多的改善方法中，以機械性噪音源的改善最為有效，平均降幅為11.72分貝，改善幅度為14.47%。在非機械性噪音源的改善亦達到本專案改善目標，平均降幅為10.5分貝，改善幅度為14.0%。雖然有12項噪音降低措施是有效的，若依美國環保署標準，我們只能確保50%的ICU患者減少受到噪音的危害，故建議醫院應建立一套常規化的噪音防治與監測機制，以確保所有改善措施能運作順暢。

This project was the result of numerous complaints from patients and their families about high levels of human and mechanical noise inside the emergency intensive care unit (EICU) of a major medical center in southern Taiwan. Other complaints were made by members of the medical staff, who claimed that they could not hear the alarms built into medical equipment. The project entailed a data inventory, analysis, and the identification of noise sources. Maximum mechanical noise level was measured at 79.6 dBA. After classifying noise sources as non-mechanical or mechanical, we established a list of objectives and used 13 approaches to achieve them. As a result, average reduction in mechanical noise volume was 11.72 dBA (14.47%) and in non-mechanical noise volume 10.5 dBA (14.0%). Still, we were only successful in protecting 50% of all EICU patients from noise disturbance levels according to the guidelines established in the Noise Prevention Act that is used in the United States. We therefore recommend that noise monitoring systems be added in order to increase the percentage of EICU patients who are protected from unnecessary noise.