Healthcare Design - August 2014 - 68

Acoustic Performance:
How Flooring Affects Noise Levels in Healing Environments
Evidence shows that high noise levels in hospitals
worsen patient and staff outcomes, including sleep
quality and physiological stress. High noise levels
also impact speech recognition which is critical to
delivering good medical care. For example, Methodist
Hospital in Indianapolis, Indiana, improved its
medication error index in a coronary critical care unit
after decentralizing nursing and installing carpet in
hallways7.
The World Health Organization recommends that
noise levels in patient rooms not exceed 30 decibels
(dB)8. Studies have reported noise levels in excess
of 95 dB in patient care areas. For example, in one
Atlanta hospital's ICU, daytime noise levels reached
96 dB at shift changes. This is in the range of noise
levels at an NFL game, rock concert and the New
York City subway9.

The Centers for Medicare and Medicaid Services
(CMS) holds hospitals accountable for high noise
levels. CMS will not reimburse hospitals for serious
hospital-acquired conditions identiﬁed as "never
events"-adverse events and complications deemed
"reasonably preventable" through the use of
evidence-based guidelines10.

Patients taking sedatives to combat sleep
disruptions, increased heart rate and other effects
of hospital noise could be at higher risk of falling12
which could lead to injuries. Additionally, high noise
levels in hospitals can potentially contribute to
reduced speed of patient wound healing;13 unhealed
wounds are potential sites for nosocomial infections.

Medication errors, injuries caused by patients falls
and hospital-acquired (nosocomial) infections are all
considered never events. A study of 112 medication
errors and near misses in a UK psychiatric hospital
found that 15 percent of the errors had the potential
to cause moderate or severe harm to patients. One
of the most common factors cited by nurses as
contributing to medication errors was a busy, noisy
environment11.

CMS also links reimbursements for patient stays
to a hospital's scores on the Hospital Consumer
Assessment of Healthcare Providers and Systems
(HCAHPS) survey. This survey asks recently
discharged patients about their hospital experience.
Results are posted online at www.hospitalcompare.
hhs.gov. On average, the results show that patients
are most dissatisﬁed with the "quietness of the
hospital environment".14 The lower the satisfaction
score, the smaller the reimbursement.

See J+J Flooring Group's Technical Paper Titled "How Flooring Affects Acoustic Performance" for citation information. http://www.jj-kinetex.com/technical/technical-papers/

Kinetex Textile Composite Flooring
Offers Outstanding Acoustic Properties
Airborne Sound
A ﬂoor covering's measure of effectiveness in absorbing airborne
sound is expressed as a Noise Reduction Coefﬁcient (NRC). The
greater the absorption, the higher the NRC number. A surface that
completely eliminates sound has an NRC of 1.0.
Hard surfaces such as rubber and vinyl typically have NRCs of
about 0.0-0.015, meaning they absorb little to no airborne sound.
Commercial carpets used in hospitals, schools and ofﬁces have
NRCs typically ranging between .15 and .2, meaning they absorb
about 15-20 percent of airborne sound. Kinetex textile composite
ﬂooring features an NRC of about .30, meaning 30 percent
sound absorption. This is the highest airborne noise reduction of
comparable ﬂooring types.

Structure-borne Sound
The structure-borne noise reduction test is used to measure ﬂooring's ability to reduce impact sound transmission into the space
below. Footsteps and objects dropping on the ﬂoor are examples of
impact noises. The measure is expressed as a whole number, Impact
Insulation Class (IIC). The higher the numerical rating, the greater the
sound insulation.
IICs for VCT typically range from 15 to 20. The results for rubber
range from 15 to 30. Carpet IICs range from 35 to 50. The IIC for
Kinetex textile composite ﬂooring is 64.

http://www.hospitalcompare http://www.hhs.gov http://www.jj-kinetex.com/technical/technical-papers/

Healthcare Design - August 2014

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