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The Intensive Care Unit Environment: Impact and Prevention

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Abstract

Since the introduction of the intensive care unit in the 1970s, care and treatment has focused primarily on physical health. The advent of follow-up clinics has enabled our patients to describe the impact of an ICU stay not only on their ongoing physical function, but also their psychological, cognitive and social function. This knowledge is impacting not only patient care we consider appropriate but also the built environment and the devices we use. Sound and noise from staff conversations and medical equipment has reached an unsustainable level for patients, with the majority of the sound sources (e.g. medical equipment with alarms) placed near the patients’ head. The alarms are usually designed to be loud enough to be heard by staff who could be situated anywhere throughout the room or bay. The design of the patient room may also impact the patient’s circadian rhythm, with recommendations that patient areas in the ICU incorporate natural light. The circadian rhythm is imperative to enable sleep; therefore, this chapter commences with a review of sleep in the ICU patient. It then reviews the two main environmental stressors, noise and light intensity and how we might mitigate the negative impacts on recovery of both. Lastly, it highlights interventions that alongside sound and light management may humanise the ICU.

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Authors and Affiliations

  1. St George’s University Hospitals, NHS Foundation Trust, London, UK

    Deborah Dawson

  2. St George’s, University of London and Kingston University, London, UK

    Deborah Dawson

  3. Western Sydney University, Sydney, NSW, Australia

    Deborah Dawson

  4. Department of Anaesthesia/Surgical Operations/Intensive Care, Sahlgrenska University Hospital, Gothenburg, Sweden

    Lotta Johansson

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  1. Deborah Dawson
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  2. Lotta Johansson
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Correspondence to Deborah Dawson .

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Editors and Affiliations

  1. Intensive Care Unit, Royal Devon & Exeter NHS Foundation, Exeter, Devon, UK

    Carole Boulanger

  2. Therapy Services, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK

    David McWilliams

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Dawson, D., Johansson, L. (2020). The Intensive Care Unit Environment: Impact and Prevention. In: Boulanger, C., McWilliams, D. (eds) Passport to Successful ICU Discharge. Springer, Cham. https://doi.org/10.1007/978-3-030-38916-1_9

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