Quality healthcare describes the level at which healthcare services for different individuals and populations concur with the desired health outcomes that coincide with the current professional knowledge. Quality improvement, by extension, encompasses efforts that aim to reduce the quality gap for a particular group of patients. It is commonly acknowledged that sleep is an essential part of human life since it directly impacts the functioning of the body (Mariconte, Gilliberti, Cavuto, & Strigari, 2015) . Sleep becomes particularly crucial in the healthcare setti ng since the institution deals with patients. Research indicates that many healthcare facilities are noisy, and the current noise levels exceed the recommended standards (Kol, Demircan, Erdogan, Gencer, & Eregin, 2015) . Noise in St. Williams’s healthcare facility comes from different sources, including but not limited to machine and equipment, staff interactions, roommates, alarms, intercoms, and pagers. Since sleep is essential, noise at night in the healthcare setting induces noise-related stress, which is detrimental not only to the patients but also to their family members. The paper proposes night time noise reduction in the efforts of promoting the delivery of quality healthcare in a productive hospital environment.
Purpose
There is extensive literature that illustrates sleep is a biological necessity. Similarly, research asserts that lack of sleep or disturbed sleep is directly related to a multitude of health problems (Cunha & Silva, 2015) . Indeed, noise increases anxiety and stress triggering specific physiological responses such as grimacing, muscular flexion, increased blood pressure, increased heart rate, and vasoconstriction as such, reducing the patients' ability to fall asleep. All these responses, in addition to a lack of sleep work to slow the healing process of the patients admitted at the hospital (Mazer, 2012) .
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Additionally, healthcare professionals performance is adversely affected in a noisy environment; it increases complaints of exhaustion and burnout in addition to increased irritability. The purpose of the current proposal is to estimate the current noise level in the hospital unit in addition to contributing to the maintenance of a sound environment. Additionally, the initiative will generate awareness on the extensive health consequences associated with noise in the healthcare setting.
Target Population
The target population is the entire healthcare facility since several groups are at risk due to hospital noise, particularly at night. Moreover, several entities in the hospital, including the administration and the staff, contribute to the noise. Mainly, older adults and pregnant women are at a higher risk in addition to children (Mariconte, Gilliberti, Cavuto, & Strigari, 2015) . Healthcare professionals such as nurses and other shift workers are also at risk as their sleep structure, and working productivity is under stress in the event of excessive noise within the healthcare premises. Therefore, the change is directed towards the St. Williams healthcare facility administration and the staff in addition to creating awareness among the patients on how the disruptive late-night noises are inducing stress, lack of sleep and subsequently prolonging their recuperation period.
Benefits
It is well-documented that several aspects of health in addition to the quality of life are directly associated with sleep. Therefore, it is deductible that disturbance in sleep impairs these aspects as such, reducing not only health but also the quality of life (Kol, Demircan, Erdogan, Gencer, & Eregin, 2015) . Indeed, sound sleep is essential for patients and even their family members. It is vital for various measures to be taken to ensure a peaceful and quiet environment within the healthcare facility, especially at night. The influence of sleep in the functioning of the body and quality of life implies that it should be approached as a component of patient care in the healthcare facility.
Moreover, research indicates that several healthcare facilities in the USA have initiated the reduction of noise in the facility and many have had a positive impact on health outcomes (Kol, Demircan, Erdogan, Gencer, & Eregin, 2015) . The premise of noise reduction at night is grounded on the fact that sound sleep facilitates effective functioning of the body, which supports the healing process and subsequently, early discharge from the facility. Extensive literature showcases that many healthcare facilities are sources of infection for admitted patients, which pinpoints the importance of an intervention intended to shorten the recuperation period (Cunha & Silva, 2015) . Noise reduction endeavor promotes the patients’ health in addition to increasing hospital rating s (Berkowitz, 2016) . Sleep deprivation may increase patients’ dissatisfaction, which directly affects the hospital rating and has the potential of affecting St. Williams long-term revenue.
Cost Justification
Through observation and secondary research, the most disruptive noise in St. Williams healthcare facility is the staff conversations. However, there are other sources of noise, including intercoms, pagers, equipment, and machines. To manage the noises of noise, it is necessary for the healthcare facility to dedicate resources on educating the staff in addition to effective planning. The cost of educating the staff merely encompasses training on how noise adversely affects health outcomes, and such as a cost is minimal (Kol, Demircan, Erdogan, Gencer, & Eregin, 2015) . Planning involves efforts to ensure that the healthcare professional at work during the night shift can be effectively paged with extensively disrupting the patients.
Additionally, the hospital can reduce the noise by utilizing the Yacker Tracker, which is essentially a noise alerting device. The Yacker Tracker informs the nurse in charge and other shift professionals when the noise level has extended beyond the recommended levels. According to amazon.com, the Yacker Tracker costs approximately 100 dollars, and each unit requires at least two devices, one of the nurse stations and the other one for the hallway.
Project Evaluation
The assessment process is vital in ensuring the effectiveness and continuation of the project in the future. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) can be applied in the assessment before and after the implantation of the project (Berkowitz, 2016) . Prior to implementation, the sound evaluation will be conducted to estimate the noise level in each unit of the healthcare facility. The same technique is applied to determine the noise-level after implantation of the project, and the difference between the two periods is measured statistically. In conclusion, the night-time noise reduction initiative will work to reduce noise in the healthcare facility in a cost-friendly way while providing a suitable environment for the patient's recuperation and staff productivity. Indeed, the project will provide one answer behind the question of the current declining quality of the hospital environment.
References
Berkowitz, B. (2016). The patient experience and patient satisfaction: Measurement of a complex dynamic. The Online Journal of Issues in Nursing, 21 (1).
Cunha, M., & Silva, N. (2015). Hospital noise and patients' well-being. Social and Behavioral Sciences, 171 , 246-251.
Kol, E., Demircan, A., Erdogan, A., Gencer, Z., & Eregin, H. (2015). The effectiveness of measures aimed at noise reduction in an intensive care unit. Workplace Health and Safety .
Mariconte, R., Gilliberti, C., Cavuto, C., & Strigari, L. (2015). Noise in healthcare facilities. The 22nd International Congress on Sound and Vibration. Florence.
Mazer, S. E. (2012). Creating a culture of safety: Reducing hospital noise. Biomedical Instrumentation and Technology, 46 (5), 350-355.
