• As a nurse, I’ve often noticed the importance of sleep in my patients’ recovery. When I realized that it was a problem, that our patients were having difficulty getting rest due to the noise and disturbances, I knew that I wanted to find a solution. That’s why I got involved in this project.

  • I soon realized that we had to be bold and do things differently. Funnily, we had to work with technology to be able to restore the basis of patient care: sleep.

    It’s not always easy to talk more quietly, to make less noise, in addition to all the equipment that is constantly going off, but the Intensive Care team was open to change and embarked on this adventure to improve the care we offer our patients.

  • Looking back, I’m certainly proud of the work we accomplished and I see the benefits for our patients, but I’m also aware that I personally gained from this project since it was a learning experience that allowed me to grow as a healthcare professional.

An essential element of recovery is rest.

But trying to sleep when a heart monitor is beeping, while material is being delivered in front of your room, doors are constantly opening and closing, or there is a shift change… Not an easy feat!

This is precisely the problem identified by the Intensive Care team who worked to find solutions to reduce noise and allow our patients to get more rest.

Over the last few months, the team had received an increased number of complaints from patients about noise and interrupted sleep.

Noises of over 105 decibels were heard

between 20 and 30 times per hour
with a peak of 70 times around 11 am
and dozens of times in the middle of the night

Too much noise and a lack of sleep hinder recovery, and can lead to complications and longer hospital stays.

« It was a very noisy environment. My neighbour’s machine was constantly beeping… I couldn’t get any rest.»

Patient complaint

Rico Audet, a clinical informatics specialist, was on loan from his position to lead the project. Consultations were held with members of the unit’s staff and a patient partner. Rico made a surprising discovery.

Staff members were the leading source of noise!

The team realized that they had to address work habits and culture. An improvement plan was developed. Rico and the team started by creating customized training and, to date, all nurses in Intensive Care, along with certain other professionals, have received it. The training is now a component in the orientation of any future nurses on the unit.

100% of Intensive Care nurses have completed the training

The team changed the default parameters on the heart monitors to reduce needless alarms, which brought down a lot of the noise in the patients’ immediate environment. At Rico’s suggestion, a SoundEar III decibel metre, a device that warns people when they are making too much noise, was installed. The device produces reports on trends, which makes it possible to determine when noise is at its worst and to remedy the situation.

“I think that this initiative will help us give better patient-centred care. We’re already seeing a difference, even during the day.”

Isabel Smith
Registered nurse in Intensive Care, Montfort

Officially in effect since December 18, 2017, these measures have been well received. “People seem to be more aware of their actions and the sources of noise."

The project will be replicated in other sectors of the hospital since the Montfort Hospital Foundation has purchased ten new decibel metres which will soon be installed in various units.

For this improvement project, Rico received funding from the Advanced Clinical Practice Fellowship of the Registered Nurses’ Association of Ontario. This program provides nurses, like Rico, the opportunity to have a focused self-directed learning experience to develop clinical, leadership or best practice guideline implementation knowledge and skills.

Rico took advantage to develop his project within the framework of the Lean Green Belt training. This enabled him to use the tools from this methodology to attain the objectives. Rico’s project also won him the 2018 Sirius Award for innovation during Montfort’s Gala du mérite.

“Without this learning opportunity, the project probably would never have seen the day.”

Rico Audet
Clinical Informatics Specialist, Montfort

Rico’s project is part of Montfort’s Strategy 2021 to "achieve the attributes of an academic teaching hospital", while allowing our “people to benefit from activities supporting the development of a culture of knowledge.”