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While Florence Nightingale identified noise as a risk factor over 150 years ago, current hospital environments remain characterized by auditory clutter: technologies, larger patient/visitor populations, and physical spaces that are, themselves, noisy. While nurses are far from the sole cause of unacceptable noise, Nightingale established, as a primary task of nursing, that the control over patient environment, the "sick room", is within the domain of nurse control.


Florence Nightingale, in her seminal work Notes on Nursing, wrote


“Necessary noise is that which damages the patient… Unnecessary noise is the cruelest absence of care.”


Today, we can add nursing and medical errors to the list of risks posed by a noise-laden environment. Sound-alike drugs become almost indistinguishable when amassed with auditory clutter. The auditory environment must exemplify the highest and most compassionate standards of patient care. Setting sound standards for equipment, technology and design makes it possible for a patient to move through the healthcare system, from department to department, and experience the same standards of care. Aim for more than auditory neutrality as the myth of “do no harm” when it comes to noise and distraction, by providing music and nature, fountains, or other pleasant sound sources that can improve the quality of the healthcare experience.


Advice and guidance for the acoustic design of healthcare premises is set out within the NHS Estates publication: Health Technical Memorandum (08-01).