Samenvatting

Introduction: Communication is an essential part of nursing care. While conversations with patients mainly take place in patient rooms, the ward corridor is often used for communication between staff members and sometimes visiting family. As many patients suffer from hearing loss due to biological ageing, loud conversations between staff and patients which can be overheard in the corridor are no exception. The acoustic design of nursing wards should facilitate communication yet not compromise other tasks of the professional that take place here.

Aim: To gain insight in the relation between the auditory environment in a hospital ward on nurses’ cognitive performance and quality of care.

Materials and Methods: A three day observational study and a follow up literature study have been conducted in a Dutch hospital ward. Researchers shadowed a nurse during three full shifts and kept a log of activities and environmental aspects which were combined into a general overview of the shift. The literature study was conducted to support the findings from the observations.

Results: Nursing consists of completing various tasks in the most efficient and patient-centered order. The biggest risks for patient safety and comfort seem to be medication errors and negligence. This is supported by Potter who introduced the term cognitive stacking in 2005. Voices and television sounds from patient rooms are loud and can be heard in the ward corridor. Ringing telephones and conversations between nurses and family are the most common sounds in the corridor. Literature findings suggest that interruptions of nursing care are an important aspect in medication errors and other care omissions. Most of these findings were, however, based on visual disruptions of the care process. In addition, while the distractive effects of background sounds have been investigated for a range of cognitive tasks, no such experiments are known for the cognitive stacking that is typical for nursing care and involves both the execution of several cognitive tasks and the decision-making of workflow priorities.

Conclusions: The results lead to the hypothesis that auditory events influence nurses’ cognitive performance. Structured observations in multiple wards to quantify and analyze distractions are needed to strengthen this hypothesis.