Assessment of Medical-Surgical Patients' Perception of Hospital Noises and Reported Ability to Rest.

Objectives: The purpose was to determine if an enhanced privacy curtain (1) impacted ability to rest while hospitalized in the acute care setting and (2) improved patient satisfaction associated with environmental noise.

Methods: The project evaluated a privacy curtain designed to increase speech privacy and intelligibility and reduce reverberation time (echo). The curtain was similar to the existing privacy curtain with 2 exceptions: the curtain panel had pocket inserts that absorbed sound, and curtain panels could be zipped together to reduce sound transmission through gaps.

Acoustic assessment of speech privacy curtains in two nursing units.

Hospitals have complex soundscapes that create challenges to patient care. Extraneous noise and high reverberation rates impair speech intelligibility, which leads to raised voices. In an unintended spiral, the increasing noise may result in diminished speech privacy, as people speak loudly to be heard over the din.

Effect of hospital noise on patients' ability to hear, understand, and recall speech.

Speech intelligibility and recall were examined in normally hearing and hearing-impaired hospitalized patients. Fifty-two participants completed testing in a sound-attenuated booth. While listening to a recorded male speaker talking at conversational level, participants were asked to identify and remember the last (key) word in each of a series of five sentences presented in hospital noise with or without voices at three decibel levels (59, 64, and 69 dBA).

Evaluating an insulin infusion protocol in an acute care setting.

Objective: The objective of the present study was to evaluate the adherence, safety, and effectiveness of a paper versus an electronic insulin infusion protocol.

Design: This quasi-experimental implementation study compared experimental and control groups using a nonrandomized prospective cohort design.

Setting: The study was performed at 2 surgical units within a federal tertiary care teaching hospital.

South African TB nurses' experiences of provider-initiated HIV counseling and testing in the Eastern Cape Province: a qualitative study.

This study addressed factors that played a role in the limited but effective implementation of provider-initiated HIV counseling in tuberculosis (TB) clinics in the Eastern Cape Province, South Africa, as part of a clinical trial. The Eastern Cape is a region with some of the highest TB and HIV rates in the world. The parent study was a pragmatic, cluster-randomized trial designed to measure the impact of provider-initiated ("opt-out") counseling on the uptake of HIV counseling and testing in newly registered TB patients.

A cluster-randomized trial of provider-initiated (opt-out) HIV counseling and testing of tuberculosis patients in South Africa.

Objective: To determine whether implementation of provider-initiated human immunodeficiency virus (HIV) counseling would increase the proportion of tuberculosis (TB) patients who received HIV counseling and testing.

Design: Cluster-randomized trial with clinic as the unit of randomization.

Setting: Twenty, medium-sized primary care TB clinics in the Nelson Mandela Metropolitan Municipality, Port Elizabeth, Eastern Cape Province, South Africa.

Survival of patients with pulmonary tuberculosis: clinical and molecular epidemiologic factors.

Using restriction fragment-length polymorphism data, we conducted a retrospective cohort study of 139 adult patients with pulmonary tuberculosis to investigate the clinical impact of Mycobacterium tuberculosis infection with a clustered isolate. The cumulative all-cause mortality rate during treatment was 21%. Patients with clustered DNA fingerprint patterns had a reduced risk of death, compared with patients with unique patterns (hazard ratio [HR], 0.