Date of Graduation

Fall 12-12-2014

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Dr. Vandeveer


Background The CCU staff recognized a department trend for low patient-satisfaction score related to environmental noise levels. Based on the Press Ganey score, the patient-satisfaction score plummeted in relation to noise level beginning in March 2014.

Purpose To improve patient satisfaction regarding noise level in the CCU to 100% by November 21, 2014.

Methods Senior & Fleming’s Hard System Model of Change guided this literature search of CINAHL and Fusion for articles published from 2009 to 2014. Specific terms used were noise, critical care, and sleep promotion. From September to November 2014, earplugs were offered to all alert/oriented patients entering the CCU. Data were analyzed using the tracking tool for earplugs and the CCU Press Ganey scores for noises in and around the patient room.

Results A direct result of staff education, staff/patient awareness, and the availability of ear plugs resulted in a dramatic increase in patient perception of reduced noises on the Unit. CCU Press Ganey score increased to 93.8 compared to magnet mean for like hospitals of 79.4. While approximately half of the alert/oriented patient population in the CCU elected to use earplugs for sleep, patient perception of reduced noise levels increased. Patients declined use of the earplug for various reasons with the most common being hearing loss, visual loss, and anxiety.

Nursing relevance Patients who elected not to utilize earplugs for sleep reported they were pleased that such an option existed and perceived the nursing staff as being interested in their overall wellbeing. Nursing staff also reported increased recognition of elevated noise (talking at nursing station) and worked to decrease loud talking amongst staff members.