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Shhhhh ... It's Quiet Time

Family Matters - Winter 2011

Hospital units are usually described as noisy areas and are not often thought of as restful places for patients, family and visitors. Patients comment that they have few uninterrupted peaceful moments in the midst of a stressful experience.

“It makes a big difference in your hospital stay,” Val Marshall, mother of patient Addison Marshall, comments. “I’ve noticed that nurses are making a concentrated effort to keep the lights and voices low during the designated hours. Last fall, we were placed on a floor without Quiet Time and both Addison and I were ready to return to Floor 9 where we could look forward to some enforced silence.”

Quiet Time pilot in the Children's Cancer Hospital

Originally program through the Transforming Care at the Bedside initiative, Quiet Time was piloted in the Children’s Cancer Hospital in September 2010. The concept was presented by Julie Segovia, clinical services director for the Children’s Cancer Hospital, to the Family Advisory Council for parental interest and then again at the Clinical Issues meeting for the interest of staff and for pilot planning purposes.

The experiment was a success with positive feedback from all sides. Parents and caregivers were impressed about the concern for their psychosocial needs and the awareness of a traditionally noisy hospital environment.

Quiet Time is now a policy for the Children’s Cancer Hospital. The hours of 2:00-3:00 p.m. on the dayshift and 10:00-11:00 p.m. on the nightshift are designated for this program.

What 'quiet' really means

The new policy recognizes that a patient’s rest on an inpatient floor may often be interrupted by noises such as:

  • staff and caregiver conversations,
  • multidisciplinary team and staff rounds,
  • vital signs, medical equipment and alarms,
  • food, supply and medication delivery supplies,
  • bed motors,
  • telephone/paging devices,
  • computer keyboards and printers,
  • opening and closing doors,
  • footsteps, and
  • other distractions.

These noises may seem common and a part of a normal work day, but they can result in such consequences as sleep deprivation, anxiety, stress, cardiovascular stimulation, reduced pain tolerance, emotional and mental deficits, altered immune function, decreased wound healing and delayed recovery for our patients.

For success, certain behavioral modifications are necessary:

  • Nurses are asked to ensure that patients’ immediate needs are met prior to Quiet Time.
  • Nurses and staff attend to alarms quickly.
  • Prolonged conversations are held in areas other than the nurses' station.
  • All staff and visitors are asked to speak in low tones.
  • All members of the multidisciplinary teams are asked to participate in Quiet Time and conduct their rounds accordingly.

In addition, other modifications have been made. Lights are dimmed, doors to patients’ rooms are closed, overhead paging is reduced, ringer volume on telephones is decreased and all members of the multidisciplinary teams are encouraged to avoid conducting patient rounds. Posters announcing Quiet Time are displayed in pods, too.

“I’m encouraged with the collaboration of families, patients, nursing, child life, physicians, social work, education, physical therapy and all of the multiple disciplines that were a part of this initiative to provide patients and families with designated quiet time. The quiet hours give everyone an opportunity to refresh and be protected from noise and interruptions,” Segovia says. “We’re here to provide the patients with clinical services that exceed their expectations, and we actively listen to gather information in order to provide those services.”

© 2015 The University of Texas MD Anderson Cancer Center