Perceived ICU Alarm-Noise Burden, Staff-Reported Health Effects, and Contextual Objective Night-Time Acoustic Monitoring in an Adult Intensive Care Unit.

OBJECTIVE

To examine intensive care unit (ICU) staff-perceived alarm-noise burden and related health, communication, workload, and alarm-response outcomes, contextualized by usual-care night-time acoustic monitoring.

METHODS

We conducted a single-center observational study combining an electronic survey of ICU healthcare professionals with contextual bed-level night-time acoustic monitoring. The survey assessed perceived unit noise, alarm-related health and performance effects, communication interference, alarm-response behavior, alarm-governance perceptions, modified workload, and noise sensitivity. Acoustic outcomes included the equivalent continuous sound level, the maximum sound level, and the time above 80 dBA. Acoustic data were not linked to individual staff responses. Descriptive statistics, Cronbach's alpha, Spearman correlations, and exploratory multivariable regression were used.

RESULTS

Among 124 respondents, 83 were nurses, 20 were respiratory therapists, 18 were physicians, and 3 were allied health/other staff. Median perceived unit noise was 7/10 (interquartile range, 5-8), and 67 respondents (54.0%) rated noise as high. Excessive alarms triggered physical symptoms in 70 (56.5%), reduced work performance or motivation in 63 (50.8%), affected concentration or attention in 60 (48.4%), and interfered with communication in 48 (38.7%). Twenty-eight respondents (22.6%) reported missed alarms due to sensory overload.

CONCLUSION

ICU alarm noise was perceived as an occupational health and workflow burden. Contextual acoustic monitoring showed measurable night-time sound exposure. Quiet ICU interventions should combine alarm hygiene, escalation governance, workflow redesign, central alarm visibility, and objective acoustic surveillance while preserving patient safety.