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Title Environmental noise as risk factor for postoperative delirium in an orthopedic sample: an exploratory, correlational study
Publication Date
Degree Level doctoral
University/Publisher University of North Carolina – Greensboro
Abstract Postoperative delirium (PD) affects approximately 25 percent of participants over the age of 60 having major surgery. Long term negative effects include persistent delirium, loss of independence, nursing home placement, and mortality. There is evidence that incidence is related in-part to multifactorial precipitating and predisposing factors; however, none of the studies found evaluated perioperative environmental factors. One environmental factor that may influence the severity of PD is intraoperative noise. A surgical population with an increased incidence of delirium is orthopedic surgery. Orthopedic surgery, such as total hip or knee arthroplasties, involves the use of equipment such as loud drills and saws. The incidence of PD in those having orthopedic procedures is between 41% and 50%. The purposes of this study were to describe the environmental noise in an orthopedic operating room environment during arthroplastic surgery and to explore the relationship operational noise variables to the incidence and severity of PD. The correlational design is a non-experimental method chosen to examine the strength of the relationship between perioperative noise in the orthopedic total knee or hip arthroplasty suite and the incidence of PD. A convenience sample was comprised of participants presenting at their pre-anesthesia assessment visit and ending when the calculated sample size has been reached. This exploratory study demonstrated inconsistent findings in relation to noise loudness and pitch variables and delirium severity. However, all noise levels exceeded US governmental agencies recommended maximum levels and may put patients and personnel at risk. More research is needed to further investigate hospital noise and outcomes.; Postoperative delirium, Orthopedic surgery, Elderly, Environmental noise
Subjects/Keywords Orthopedic surgery – Complications; Noise – Physiological effect; Delirium
Contributors Beth Barba (advisor)
Country of Publication us
Record ID oai:nc-docks:15476
Repository nc-docks
Date Retrieved
Date Indexed 2018-06-27
Grantor The University of North Carolina at Greensboro

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…most important aspects related to elder health is overall functional status and subsequent independence (ACL, 2013). Postoperative delirium (PD) affects approximately 28 % of participants over the age of 60 having elective surgery

…presents following a surgical procedure. The incidence of delirium ranges from 10% to 60 % in the postoperative population (Inouye, 2006). The incidence of PD varies among types of surgical procedures. Those having orthopedic procedures show an 2…

…cognition or behavior. Research Questions 1) What is the description of environmental noise (loudness and pitch) in an orthopedic surgical suite? 2) When controlling for psychological (baseline cognitive status, noise annoyance, and…

…noise sensitivity) and functional (activities of daily living) characteristics of the individual, which characteristics of intraoperative noise (loudness and pitch) explain the severity of PD in an orthopedic surgical sample of…

…the operating room environment of elderly participants having orthopedic 6 arthroplastic surgeries and to explore the relationship of intraoperative noise (loudness and pitch) to the severity of PD. Arthroplasty procedures involve the…

…replacement of severely damaged knee or hip joint cartilage or bone with metal and plastic prostheses (American Academy of Orthopedic Surgeons, 2007). The outcomes of this study may yield future research regarding environmental milieu of the…

…potential outcome. Because the predisposing risk factors for delirium have been identified, the “Pre-surgical person at risk for PD” is conceptually defined as a person presenting for surgery who will be exposed to physical internal, polypharmacy, and…

…adapted framework for study of environmental noise as stressor for delirium. Conceptual Definitions Pre-surgical patient at risk for delirium: Pre-surgical patient at risk for PD theoretically is a person presenting for surgery who will be exposed to…