降低血液透析室環境噪音之專案

Reducing the Noise Level in the Hemodialysis Ward

10.3966/172674042015061402001

平曉晴(Hsiao-Ching Ping)；曾雅婷(Ya-Ting Tseng)；林妮妮(Ni-Ni Lin)；謝春滿(Chun-Man Hsieh)

透析室 ； 環境 ； 安寧 ； 噪音 ； hemodialysis room ； environment ； quietness ； noise

臺灣腎臟護理學會雜誌

14卷2期（2015 / 06 / 01）

1 - 13

繁體中文

根據本單位護理服務滿意度調查，發現「環境保持安靜」滿意度最低，故本文旨在介入改善專案以營造透析治療室之安寧環境。經分析發現單位噪音平均音量為83.1分貝，超過50分貝之平均發生噪音頻率659次／日之主要原因有：（一）護理人員透析標準作業及警報處理認知不一且人員缺乏維護環境安寧之警覺；（二）透析前透析機之標準作業、訪客規範及電話管理有缺失；（三）電話設置位置、儀器音量調降及注意音量警語等設施缺失；（四）訪客或家屬人數無限制且缺乏環境安寧警覺等。解決辦法包含：在職教育、設置交班區；增設透析前準備標準作業、制定訪客須知暨電話管理辦法；電話設置於合適位置且將儀器設備音量合宜調降；設置談話區等。改善後，平均音量降至62.7分貝，平均發生噪音頻率降至324次／日，達成專案目標且有助於降低噪音，建議作為類似單位營造優質安寧環境之參考依據。

According to the nursing service satisfaction survey, ＂maintaining a quiet environment＂ was the least satisfactory item. This project aimed to improve the environmental noise in the hemodialysis ward. Analysis measured the average noise volume to be 83.1 dB in the ward and on average the decibel level exceeded 50 dB 659 times per day. The major causes of this problem included: (1) inconsistent dialysis procedures and a lack of noise discipline among the staff; (2) deficiencies in the dialysis machine operating manual, telephone management, and visitor management regulations; (3) deficiencies in the facilities including inappropriate phone location, instrument volume settings and noise awareness signs; (4) too many relatives during the visiting time and a lack of awareness on the need to maintain a quiet environment among visitors. Strategies to improve the ward noise level included providing on the job training and setting up a fixed staff handover area; addition of a pre-dialysis standard operating procedure, telephone management and visitors management regulations; relocation of telephones and decreasing the volume of dialysis machines, and establishing a chat area for visitors. These strategies decreased the average decibel level from 83.1 to 62.7 dB. The frequency with which the decibel level exceeded 50 dB was decreased from 659 times to 324 times per day. This project was therefore successful in its goal of improving environmental noise. Similar units should consider using this as a reference for improving environmental noise in the hemodialysis ward.

1. Basner, M.,Babisch, W.,Davis, A.,Brink, M.,Clark, C.,Janssen, S.,Stansfeld, S.(2014).Auditory and non-auditory effects of noise on health.The Lancent,383(9925),1325-1332.
2. Cordova, A. C.,Logishetty, K.,Fauerbach, J.,Price, L. A.,Gibson, B. R.,Milner, S. M.(2013).Noise levels in a burn intensive care unit.Burns,39(1),44-48.
3. Hu, B. H.,Cai, Q. F.(2010).Acoustic overstimulation modifies Mcl-1 expression in cochlear sensory epithelial cells.Journal of Neuroscience Research,88,1812-1821.
4. Johansson, L.,Bergbom, I.,Waye, K. P.,Ryherd, E.,Lindahl, B.(2012).The sound environment in an ICU patient room: A content analysis of sound levels and patient experiences.Intensive and Critical Care Nursing,28(5),269-279.
5. Otenio, M. H.,Cremer, E.,Claro, E. M. T.(2007).Noise level in a 222 bed hospital in the 18th health region.Brazilian Journal of Otorhinolaryngology,73(2),245-250.
6. Short, A. E.,Short, K. T.,Holdgate, A.,Ahern, N.,Morris, J.(2011).Noise levels in an Australian emergency department.Australasian Emergency Nursing Journal,14(1),26-31.
7. 行政院環境保護署（2013）．噪音管制資訊網：噪音污染管制．取自http://ncs.epa.gov.tw/AA/A-01.htm
8. 李彩緣,葉淑芬,李姿月,游顯妹(2013)。病房環境噪音之改善專案。北市醫學雜誌，10(1)，48-57。
9. 林怡君,李晴玉,楊雅晴,黃秋綿(2008)。某新生兒加護病房音量改善。志為護理，8(5)，75-84。
10. 唐秀燕,董婉君,羅映喬,江姿瑢,梁蕙芳(2013)。降低某區域教學醫院外科病房噪音分貝量之行政專案。長庚科技學刊，18，131-140。
11. 鄔恒斐,洪文惠,許秀珠,林碧珠,張芳瑜(2009)。北部某醫學中心病房安寧滿意度改善專案。志為護理，8(2)，83-92。
12. 劉美玉,許輔宸,郭素娥,張肅婷(2008)。門診病患滿意度之分析探討。中山醫學雜誌，19(2)，209-220。