Characteristics of the Nighttime Hospital Bedside Care Environment (Sound, Light, and Temperature) for Children with Cancer

Lauri A. Linder, PhD, APRN, CPON; Becky J. Christian, PhD, RN

Cancer Nurs. 2011;34(3):176-184.

Implications for Research

Areas for future research include investigating sources of nighttime sound and their relative intensities in the inpatient hospital setting. Multiple sources of noise are present in the pediatric oncology patient's hospital room throughout the night, including nursing care activities, infusion pumps, high-efficiency particulate-absorbing filter fans, and the presence and activities of the child's parents or other visitors. The present study investigated only sound intensity level near the child's bedside, but did not distinguish the source of the sound.

Studies also are needed to delineate sources of sound that are potentially modifiable by pediatric oncology health care providers such as sound intensity associated with nursing care activities such as medication administration and routine patient monitoring and assessment. The contribution of parents and visitors to nighttime sound levels at their children's hospital bedside has not been investigated and warrants attention in future studies. Comparison of sound levels at the nurses' station or in the hallways outside the child's hospital room with those occurring in the patient's room has not been studied. As sources of increased sound intensity are identified, intervention studies aimed at reducing nighttime sound levels and reorganizing nighttime clinical-care activities that contribute to increased sound levels are warranted.

Studies investigating patient outcomes of exposure to excessive environmental noise are needed. To date, studies have identified associations between increased sound levels and impaired sleep in critically ill pediatric and adult patients.^{[1,4,8,24,25]} Associations between increased sound levels and measures of stress, including tachycardia and subjective reports of stress and annoyance, have been identified among intensive-care nurses.^[26] Future studies are needed to examine relationships between the care environment and children's physiological and psychological outcomes, including self-reported symptoms.

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Cite this: Characteristics of the Nighttime Hospital Bedside Care Environment (Sound, Light, and Temperature) for Children with Cancer - Medscape - May 01, 2011.

Abstract and Introduction
Purpose
Review of the Literature
Study Methods
Results
Discussion
Study Limitations
Implications for Research
Implications for Clinical Practice and Policy
Conclusions
References

Table 1. Summary of Sound, Light, and Temperature by Time Interval Across Each Study Night
	Night 1 (n = 15)			Night 2 (n = 15)			Night 3 (n = 14)
	Sound, dB	Light, lumen/ft²	Temperature, °F	Sound, dB	Light, lumen/ft²	Temperature, °F	Sound, dB	Light, lumen/ft²	Temperature, °F
Time interval 1 (7:00–8:59 PM)
Mean	55.1	8.0	72.9	55.3	3.1	73.0	54.6	2.9	72.8
SD	5.4	2.3	0.3	4.7	0.8	0.1	4.8	2.3	0.2
Range	41.9–84.3	0.4–33.3	70.9–75.8	41.9–78.6	0.4–15	69.9–76.9	40.4–82.0	0.4–20.1	70.9–74.9
Time interval 2 (9:00–10:59 PM)
Mean	52.6	1.8	72.6	52.2	1.4	72.9	51.3	3.2	72.7
SD	4.7	1.1	0.2	4.8	0.4	0.1	4.8	1.3	0.2
Range	42.1–83.2	0.4–15	70.7–75.8	41.6–84.8	0.4–9.9	70.4–76.7	40.5–80.0	0.4–17.9	70.8–74.7
Time interval 3 (11:00 PM–12:59 AM)
Mean	47.6	1.0	72.5	48.8	1.1	72.8	48.3	1.1	72.6
SD	2.5	0.2	0.2	3.0	0.4	0.1	4.2	0.2	0.1
Range	41.5–73.0	0.4–1.1	70.4–77.4	42.2–72.2	0.4–13.5	70.4–76.0	40.7–78.9	0.4–13.5	70.6–74.7
Time interval 4 (1:00–2:59 AM)
Mean	46.4	1.0	72.6	47.5	1.0	72.6	47.1	1.0	72.7
SD	1.1	0.2	0.1	1.9	0.2	0.1	2.7	0.2	0.1
Range	41.8–63.7	0.4–1.1	70.4–78.1	42.2–83.2	0.4–1.1	70.5–74.7	40.1–74.1	0.4–1.1	70.6–74.9
Time interval 5 (3:00–4:59 AM)
Mean	46.7	1.0	72.6	47.7	1.0	72.6	47.4	1.0	72.8
SD	1.5	0.2	0.1	1.7	0.2	0.1	1.5	0.2	0.1
Range	41.8–76.1	0.4–1.1	70.5–78.3	41.8–75.2	0.4–1.1	70.5–74.9	41.6–80.8	0.4–1.1	70.6–75.3
Time interval 6 (5:00–6:59 AM)
Mean	46.8	1.0	72.6	48.1	1.3	72.7	47.3	1.1	72.8
SD	2.2	0.2	0.2	2.0	0.6	0.2	2.0	0.2	0.1
Range	34.6–78.7	0.4–1.1	69.9–78.3	41.2–75.2	0.4–17.2	70.4–74.9	39.5–71.7	0.4–1.1	70.6–76.1

Table 2. Comparisons of Estimates of Fixed Effects of Time Interval^a of Night on Sound Level
Time of Night	Estimate	SE	t	P
Time interval 1, 7:00–8:59 PM	7.25	1.07	6.75	<.01^b
Time interval 2, 9:00–10:59 PM	3.96	1.03	3.83	<.01^b
Time interval 3, 11:00 PM–12:59 AM	0.92	0.97	0.95	.34
Time interval 4, 1:00–2:59 AM	−0.24	0.86	−0.27	.78
Time interval 5, 3:00–4:59 AM	0.06	0.67	0.10	.92
Time interval 6, 5:00–6:59 AM	—	—	—	—

^aThe basic mixed linear model automatically sets the estimate of interval 6 to 0. The estimated fixed effects of the other 5 intervals are compared with interval 6.
^b P < .01 (2-tailed).

Table 3. Comparisons of Estimates of Fixed Effects of Time Interval^a of Night on Light Level
Time of Night	Estimate	SE	t	P
Interval 1, 7:00–8:59 PM	1.84	1.02	1.81	.07
Interval 2, 9:00–10:59 PM	2.16	1.02	2.13	.03^b
Interval 3, 11:00 PM–12:59 AM	0.00	1.00	0.00	1.0
Interval 4, 1:00–2:59 AM	−0.01	0.96	−0.02	.99
Interval 5, 3:00–4:59 AM	−0.01	0.83	−0.02	.99
Interval 6, 5:00–6:59 AM	—	—	—	—

^aThe basic mixed linear model automatically sets the estimate of interval 6 to 0. The estimated fixed effects of the other 5 intervals are compared with interval 6.
^b P < .05 (2-tailed).

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Characteristics of the Nighttime Hospital Bedside Care Environment (Sound, Light, and Temperature) for Children with Cancer

Implications for Research

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References

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