MV
M. Vu
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Noise in the pediatric intensive care unit (PICU) is a persistent and well-documented problem. Sound levels in PICUs exceed guideline levels, contributing to stress and burnout among nurses, disrupted recovery in patients, and inefficiency across the healthcare system. Yet, despite decades of awareness, little has changed. Existing approaches focus on measuring noise in decibels, producing data that does not capture how sound is actually experienced and interpreted by the people working in these environments.
This thesis argues that noise in the PICU is not a technical problem but a sensemaking and empowerment challenge. Through a Research through Design approach combining literature review, observation, shadowing, and semi-structured interviews with five experienced PICU nurses at Erasmus MC Sophia Children’s Hospital, the research explored how nurses experience and interpret sound in their daily work, what prevents them from acting on that experience, and how a shared system could support collective understanding and change.
The field research identified five key themes: sound is continuously produced by overlapping sources embedded in daily care practices; noise affects nurses, patients, parents, and the system at multiple levels; nurses feel unempowered due to feeling unheard, lacking agency, and experiencing the social discomfort of confrontation; systemic barriers, including high workload, spatial constraints, and cultural resistance, prevent change; and nurses already possess the awareness, desire for collaboration, and ideas needed to improve their environment.
These findings guided the design of *StillNest*, a data commons for soundscape awareness structured across three layers: an inner layer, where individual nurses engage with sound data and contribute observations; a middle layer, where patterns become visible to the hospital; and an outer layer connecting to a broader research network. The interface design helps nurses understand sound collectively, act on it in small ways, and share responsibility for it, turning individual awareness into collective change.
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This thesis argues that noise in the PICU is not a technical problem but a sensemaking and empowerment challenge. Through a Research through Design approach combining literature review, observation, shadowing, and semi-structured interviews with five experienced PICU nurses at Erasmus MC Sophia Children’s Hospital, the research explored how nurses experience and interpret sound in their daily work, what prevents them from acting on that experience, and how a shared system could support collective understanding and change.
The field research identified five key themes: sound is continuously produced by overlapping sources embedded in daily care practices; noise affects nurses, patients, parents, and the system at multiple levels; nurses feel unempowered due to feeling unheard, lacking agency, and experiencing the social discomfort of confrontation; systemic barriers, including high workload, spatial constraints, and cultural resistance, prevent change; and nurses already possess the awareness, desire for collaboration, and ideas needed to improve their environment.
These findings guided the design of *StillNest*, a data commons for soundscape awareness structured across three layers: an inner layer, where individual nurses engage with sound data and contribute observations; a middle layer, where patterns become visible to the hospital; and an outer layer connecting to a broader research network. The interface design helps nurses understand sound collectively, act on it in small ways, and share responsibility for it, turning individual awareness into collective change.
...
Noise in the pediatric intensive care unit (PICU) is a persistent and well-documented problem. Sound levels in PICUs exceed guideline levels, contributing to stress and burnout among nurses, disrupted recovery in patients, and inefficiency across the healthcare system. Yet, despite decades of awareness, little has changed. Existing approaches focus on measuring noise in decibels, producing data that does not capture how sound is actually experienced and interpreted by the people working in these environments.
This thesis argues that noise in the PICU is not a technical problem but a sensemaking and empowerment challenge. Through a Research through Design approach combining literature review, observation, shadowing, and semi-structured interviews with five experienced PICU nurses at Erasmus MC Sophia Children’s Hospital, the research explored how nurses experience and interpret sound in their daily work, what prevents them from acting on that experience, and how a shared system could support collective understanding and change.
The field research identified five key themes: sound is continuously produced by overlapping sources embedded in daily care practices; noise affects nurses, patients, parents, and the system at multiple levels; nurses feel unempowered due to feeling unheard, lacking agency, and experiencing the social discomfort of confrontation; systemic barriers, including high workload, spatial constraints, and cultural resistance, prevent change; and nurses already possess the awareness, desire for collaboration, and ideas needed to improve their environment.
These findings guided the design of *StillNest*, a data commons for soundscape awareness structured across three layers: an inner layer, where individual nurses engage with sound data and contribute observations; a middle layer, where patterns become visible to the hospital; and an outer layer connecting to a broader research network. The interface design helps nurses understand sound collectively, act on it in small ways, and share responsibility for it, turning individual awareness into collective change.
This thesis argues that noise in the PICU is not a technical problem but a sensemaking and empowerment challenge. Through a Research through Design approach combining literature review, observation, shadowing, and semi-structured interviews with five experienced PICU nurses at Erasmus MC Sophia Children’s Hospital, the research explored how nurses experience and interpret sound in their daily work, what prevents them from acting on that experience, and how a shared system could support collective understanding and change.
The field research identified five key themes: sound is continuously produced by overlapping sources embedded in daily care practices; noise affects nurses, patients, parents, and the system at multiple levels; nurses feel unempowered due to feeling unheard, lacking agency, and experiencing the social discomfort of confrontation; systemic barriers, including high workload, spatial constraints, and cultural resistance, prevent change; and nurses already possess the awareness, desire for collaboration, and ideas needed to improve their environment.
These findings guided the design of *StillNest*, a data commons for soundscape awareness structured across three layers: an inner layer, where individual nurses engage with sound data and contribute observations; a middle layer, where patterns become visible to the hospital; and an outer layer connecting to a broader research network. The interface design helps nurses understand sound collectively, act on it in small ways, and share responsibility for it, turning individual awareness into collective change.