Susan E. Mazer, Ph.D. Blog

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Hi, and welcome to my blog! I'm Susan E. Mazer -- a knowledge expert and thought leader on how the environment of care impacts the patient experience. Topics I write about include safety, satisfaction, hospital noise, nursing, care at the bedside, and much more.

Can Hospital Noise Be Canceled by Other Noise?

May 18, 2017

Hospital noiseThis is the big question when thinking about how to reduce the negative effects of hospital noise on patients.

Noise is a sound that is unwanted, abrasive, distracting, irrelevant, and annoying. It has no distinct, uniform characteristics as being a “noise.” It is a quality assigned by listeners to what they are hearing.

The acoustic industry, which exists to control ambient noise in closed environments, has come up with several technologies. But none are an all-in-one solution for hospitals.

Acoustic Tile

The oldest and most common solution are acoustic ceiling tiles that absorb sound and limit how sound travels from one room to another. They also limit how sound reverberates in corridors and conference rooms and whether sounds can be heard through the walls.

Acoustic ceiling tiles are not an absolute solution. There are other factors in the built environment that also should be addressed, such floor and wall materials, and unit layout.

Noise Cancellation

Looking for better solutions, Acoustic engineers began examining the phenomenon of sound cancellation, developing “active noise control” (ANC) technologies. Also known as noise cancellation, active noise reduction (ANR) reduces unwanted sound by the addition of a second sound specifically designed to cancel the first.

Personal noise cancellation systems, like Bose® Noise Cancellation headphones, generate a sound that eliminates (almost all) surrounding sounds. These systems are effective in small, controlled environments.  Noise cancellation systems operate at the point of the listener.

Noise Masking

When open office layout was introduced in the early 1970s, speech privacy became an operational challenge.

Rather than canceling or reducing noise, white and pink noise generators were created to provide speech privacy where there wasn’t any. These generators add in a neutral but frequency-specific sound, similar to a fan, to make speech unintelligible so it will be clear someone is speaking, but what he or she is saying will not be understandable.  This “mask” is generated at the sound source.

Without going into too many technical details, there are risks using noise masking technologies in healthcare settings. First, it may affect the ability of a nurse to localize a sound referred to as “auditory spatial sensitivity.” If the white noise is loud enough, it may confuse the ear in determining exactly where the sound is coming from.

Hospital staff functions primarily through auditory signals, whether by monitor alarms, nurse call buttons, or patients crying out. It is critical for auditory information to be clear and understandable all the time.

White and pink noise generators can be volume controlled to fit what is needed. However, if making external noise unintelligible to patients requires a volume level that threatens the transparency of the sounds to the clinical staff, there is a risk of not hearing an important sound calling for action.

Benefits of Music

Music is often used for sound masking, most commonly experienced in restaurants. Background music provides some privacy between tables and distracts customers from hearing the ongoing clanking of dishes and people.

Offering a positive distraction, such as music, that engages patients and families does much more than mask or cancel. It draws the attention of most listeners away from adjacent conversations. Unlike noise generators that are frequency specific, music actually covers all the frequencies, limited only by the speakers through which the music is broadcast.

Music can also create an emotionally supportive context in which patients can heal and families can be comforted. The C.A.R.E. Channel nature video and music programming is produced for this specific objective and has been successful for over 25 years in creating healing environments.

So, can hospital noise be canceled by other noise?

Clearly, the challenge is more than merely covering it up or creating a quasi-silence. Creating a positive healing environment requires greater sensitivity to the needs of patients and their families, as well as looking at how staff behaves and operates.

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