Working with the HPNoSS Symposium & Workshop

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Working with the HPNoSS Symposium & Workshop

By Hanieh Motamedian, Sound Directions

“I recently had the pleasure of working alongside an extraordinary group of stakeholders on a project exploring the problem of hospital noise and the impact on staff practices, patients sleep patterns and recovery”, comments Hanieh Motamedian, Sound Directions.

“I have been very keen to explore the benefits of sound masking on wellbeing and the benefits of undisturbed sleep on patient recovery so was delighted to be asked to participate in the HPNoSS Symposium and Workshop”, adds Motamedian.

The Hospital Project on Noise, Sound and Sleep (HPNoSS) seeks to provide a holistic understanding of sound in the hospital environment and the intimate relationship of noise to sleep, rest, treatment and recovery. HPNoSS is a collaborative project between King’s College London’s Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care and the Univeristy of the Arts London, facilitated by the Cultural Institute at King’s.

Key Facts

  • Compared to 1960, hospital noise levels during the day have increased by 15dB, from 57dB to 72dB; similarly, noise levels at night increased from 42dB to 60dB.
  • Since the 1950’s, the King’s Fund observed that “hospitals are noisier than ever before” and noted how there are “numberless sources of noise and it seems that there can be no cure for all
  • In some hospital areas like the intensive care unit (ICU) sound levels always exceed 45dB and peak at just over 100dB, which is the equivalent of a lawn mower.
  • Lack of sleep hinders rest, treatment and recovery of patients; and it has been implicated in the development of delirium, increased pain sensitivity, high blood pressure and poor mental health.

The Symposium & Workshop – 14th September 2017

The HPNoSS Symposium & Workshop was held at the Chantler Simulation and Interactive Learning (SaIL) Centre, at the King’s Guys Campus.

Using a set of eight high-quality loudspeakers on stands (in kind support from the London College of Communication) a hospital soundscape was re-created in the Chantler Simulation Ward, using recordings made at an Intensive Care Unit at Chelsea & Westminster NHS Foundation Trust. Sound pressure levels (dB) and subjective measures were used to match the original environment.

During the Symposium and Workshop, a number of a number of experiments were conducted to test/compare the effects of different sound masking states on participants’ perceptions of the hospital soundscape. Experiments were also conducted to test and compare the effects of noise-cancelling and sleep friendly headphones, with and without sound masking, and participants’ perceptions and responses were solicited and recorded.

“We installed a sound masking system throughout the Chantler Ward using a set of eight speakers elevated at a height to allow us to explore the benefits of a correctly installed sound masking system in such an environment”, comments Hanieh Motamedian.

The Symposium and Workshop event also included presentations made by a broad spectrum of academics, researchers, artists, service users and clinical partners.

Group discussions explored the effects of sound masking on a hospital soundscape, the advantages and disadvantages for patients and staff of the various solutions and the potential for headphones, sound masking and noise cancellation to promote sleep and rest in hospital environments.

Qualitative and quantitative data collected during the Symposium and Workshop was analysed and found to align well with the discussions that occurred during the event, which can be read in the full report here.

Sound masking, either as an environmental solution through speakers or headphones, was perceived to be very promising.

“I genuinely felt much calmer, relaxed and undisturbed by activities surrounding me.” 

“The noise I could hear clearly before feels less pronounced and therefore less disturbing.”

“In terms of when you are trying to relax, I think this will definitely help reduce perceived noise.”

“It took me some time before noticing the added noise. I feel it helps reduce the annoyance of the noise.” 

“The overall soundscape is also seemingly louder [without masking] or more intrusive – could never sleep in this!”

“We also explored the playback of natural sounds, through the temporarily installed loudspeaker system, which appeared to have a positive change in how the hospital soundscape was perceived”, comments Motamedian.

“The raindrops sound is very soothing and relaxing.” 

“I can hear the rain very clearly- very relaxing!” 

“I loved the sound of rain in my ears.” 

“I felt more comfortable in this one- I even nodded off once! I found it more difficult to concentrate on its sound.” 

In summary, the symposium and workshop has provided lots of valuable data, reaction and insight into the effects of sound upon patient rest and staff practices and in the main, shows us that sound masking helps to create a more comfortable and relaxed environment although some participants were more sensitive to, and had stronger preference for, some of the masking sounds compared to others.

“This event was a fantastic collaboration between technical specialists, academics, service users and clinical partners and will hopefully allow a series of feasibility studies, for the implementation of the solutions explored, in real world environments”, comments Motamedian.

“I’d like to take this opportunity of thanking the HPNoSS project team, King’s College London, the University of the Arts London and the Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care for inviting us to be involved”, concludes Motamedian.

*excerpts taken from the full report compiled by the HPNoSS team, which can be  read here.

A video summary of the HPNoSS workshop can be viewed below.

HPNoSS Project Team

Dr Andreas Xyrichis
Dr John Wynne
Professor Anne Marie Rafferty
Dr Jamie Mackrill
Professor Angus Carlyle
Antoine Bertin
HPNoSS is a collaboration between King’s College London’s Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care and the University of the Arts London’s College of Communication, supported by the Cultural Institute at King’s
This event was a fantastic collaboration between technical specialists, academics, service users and clinical partners and will hopefully allow a series of feasibility studies, for the implementation of the solutions explored, in real world environments

Hanieh Motamedian

Sound Directions