{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:58:54Z","timestamp":1785499134278,"version":"3.56.0"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:00:00Z","timestamp":1780099200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Noise pollution in intensive care units (ICUs) is a pervasive occupational exposure that may affect nurses' well\u2010being, patient safety and quality of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine ICU nurses' perceptions and experiences of noise pollution and explore associations between perceived noise exposure, well\u2010being, work performance and patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A convergent mixed\u2010methods design was used. Quantitative and qualitative data were collected using structured questionnaires and semi\u2010structured interviews. Qualitative data were analysed using inductive thematic analysis in accordance with GRAMMS guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results\/Findings<\/jats:title>\n                    <jats:p>\n                      A total of 60 nurses participated in the quantitative phase, and 13 nurses participated in the qualitative interviews. A substantial proportion of nurses reported that noise often or always increased stress (56.6%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934), restlessness or discomfort (48.3%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200929), sleep disturbance (53.3%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932), fatigue or frustration (45.0%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927) and headaches (41.7%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925); 33.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) reported frequent or constant effects on decision\u2010making. Integrated analysis of quantitative and qualitative data identified three overarching themes: (1) the dual role of alarms in patient safety and workflow; (2) alarm burden as a systemic and technical challenge; and (3) strategies for managing alarm\u2010related stress.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ICU noise is functionally essential for monitoring and safety yet burdensome for nurses and patients. Individualising alarms for responding staff and using wrist\u2010vibrating bands may reduce noise burden and improve staff well\u2010being and perceived patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>ICU noise is a modifiable risk to provider health and clinical performance. Practice should move from unit\u2010wide audible alerts to targeted, non\u2010auditory systems (e.g., wrist\u2010vibrating bands) to reduce cognitive load. Clinical leaders must implement \u2018quiet zones\u2019 for high\u2010stakes tasks like medication titration and provide protected rest periods in low\u2010decibel environments to mitigate documented nurse fatigue and sleep disturbance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70527","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T13:29:12Z","timestamp":1780147752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Noise in Intensive Care Units: Occupational Exposure, Nurse Well\u2010Being and Care Quality\u2014A Mixed\u2010Methods Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-0619","authenticated-orcid":false,"given":"Saleh","family":"Salimi","sequence":"first","affiliation":[{"name":"Nursing Department Biruni University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0577-7854","authenticated-orcid":false,"given":"Farinaz","family":"Mohammadzad","sequence":"additional","affiliation":[{"name":"Nursing Department Biruni University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5855-9822","authenticated-orcid":false,"given":"Nedim Ugur","family":"Kaya","sequence":"additional","affiliation":[{"name":"Department of Audiology, School of Health Sciences Biruni University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,30]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","unstructured":"R.Dominguez M.Tapia F.Tapia et\u00a0al. \u201cPreliminary Findings on the Relationship Between Noise Exposure and Sleep Quality in DJs \u201d(2025).","DOI":"10.54941\/ahfe1006599"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ergon.2021.103136"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1735134"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP10197"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443410.2021.2002819"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12062347"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.buildenv.2021.108296"},{"key":"e_1_2_14_9_1","first-page":"1","article-title":"Latent Thinking Optimization: Your Latent Reasoning Language Model Secretly Encodes Reward Signals in Its Latent Thoughts","volume":"2","author":"Du H.","year":"2025","journal-title":"arXiv Preprint arXiv:250926314"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/su132112224"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/app15084128"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11356-022-22351-y"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/earth3030047"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCE.0000000000000885"},{"key":"e_1_2_14_15_1","unstructured":"WHO \u201cCentral Pollution Control Board: Ministry of Environment Forest and Climate Change of India \u201d(2017) https:\/\/cpcb.nic.in\/who\u2010guidelines\u2010for\u2010noise\u2010quality\/."},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12934"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-94365-8"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.4103\/nah.nah_79_21"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.12775\/QS.2024.27.55450"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/09574565211052690"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2020.102975"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2025.104234"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijans.2022.100403"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/21650799211044365"},{"issue":"2","key":"e_1_2_14_25_1","first-page":"1","article-title":"Perception and Effects of Noise in Employees of a University Hospital","volume":"11","author":"Passos P. S.","year":"2022","journal-title":"Research, Society and Development"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12117"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1258\/jhsrp.2007.007074"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.4135\/9781036232078.n9"},{"key":"e_1_2_14_29_1","volume-title":"Healthcare","author":"Filipovi\u0107 B.","year":"2025"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17228409"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrtlng.2025.09.013"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/nursrep13030083"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12414"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191811701"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/ijph.2024.1607068"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.14553"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.NNA.0000312774.42352.19"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03084-y"},{"issue":"4","key":"e_1_2_14_39_1","first-page":"1258","article-title":"Optimization of Human Resource Strategies by Investigating Employee Work Safety, Physical Health, and Psychological Well\u2010Being Within a Moderated Well\u2010Being Framework","volume":"13","author":"Bilad D. I.","year":"2024","journal-title":"Jurnal Ekonomi"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.18332\/pht\/192700"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/su17031181"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2025.104305"}],"container-title":["Nursing in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70527","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nicc.70527","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70527","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:19:16Z","timestamp":1785496756000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nicc.70527"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,30]]},"references-count":41,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/nicc.70527"],"URL":"https:\/\/doi.org\/10.1111\/nicc.70527","archive":["Portico"],"relation":{},"ISSN":["1362-1017","1478-5153"],"issn-type":[{"value":"1362-1017","type":"print"},{"value":"1478-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,30]]},"assertion":[{"value":"2026-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70527"}}