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Adatia 2015

Page history last edited by reem.elsherif@mail.mcgill.ca 5 years, 11 months ago

Adatia, Safina (2015). Introducing a Quiet Time on a Maternity Ward: Engaging Patients and Staff to Assess Benefits and Barriers. McGill Family Medicine Studies Online, 10: e01.

 

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ABSTRACT

 

Background: A postpartum hospital stay should provide new mothers an environment conducive to resting and healing. However, these patients often experience disruptions from activities related to visitors, clinical care, hospital services, and intercom announcements. This can lead to potential interruptions in important activities such as breastfeeding and teaching, and can increase the risk of postpartum mental health problems. A possible solution is a quiet time, a period of time where lights are dimmed, potential interruptions are reduced, and routine care processes are scheduled outside of this time as possible. However, only one unpublished study related to such an initiative on a maternity ward was found. The goal of this study is to contribute to the general pool of knowledge regarding noise levels and number of potential interruptions on a maternity ward along with an understanding of the benefits, barriers and implementation issues associated with the introduction of a quiet time on a maternity ward.

 

Methods: This study took place on a maternity ward in a community general hospital in Montreal. A mixed methods research design was adopted within a larger pre-post evaluation involving a participatory research approach. Noise levels were measured via Decibel 10th iPhone app; potential interruptions were noted by observation. A modified version of the Canadian Patient Experiences Survey (CPES) was distributed to inpatients. Qualitative interviews were conducted with postpartum mothers and observation notes were recorded at stakeholder meetings.An average mean A-weighted equivalent sound level (Leq) was computed, and average minimum and average maximum decibel levels were calculated and identified. We performed ANOVA and chi-square analyses of the patient experience survey results to determine characteristics of women who experience difficulty breastfeeding due to potential interruptions. Thematic content analysis was used to analyze the qualitative interviews.

 

Results: A total of 52 30-minute sessions for the measurement of noise levels and potential interruptions were completed. Average mean decibel levels across all stations were between 55-66 dB. Potential interruptions were highest from family members and nurses. 204 patients completed the CPES survey. Tests of comparison demonstrated that primips (N=115) were more likely to perceive difficulty breastfeeding due to interruptions or visitations than multips (N=84, p=0.028). Qualitative interviews were conducted with 10 postpartum women. Interviewed postpartum mothers felt that the hospital environment was noisy and that they experienced multiple potential interruptions throughout the day. All mothers felt that a quiet time would be beneficial. The interviewed mothers highlighted potential challenges to implementing the quiet time with some advice to staff and expectant mothers.

 

Conclusion: Noise levels and potential interruptions were higher than recommended WHO maximum of 30-40 dB (quiet rural area); this is consistent with other studies. Average decibel levels of 55-66 dB are similar to a washing machine. These levels of noise and potential interruptions can interfere with recovery.Potential benefits of a quiet time were identified by postpartum mothers and staff. Both postpartum mothers and staff welcomed the idea of a quiet time. The findings of this study will contribute to the larger pre-post evaluation following the implementation period.

 

 

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