September 25, 2019

Researchers explore music’s effect on ICU patients, staff

A group of Vanderbilt researchers is launching a pilot study on the effect of live music on patients, families and staff in the adult intensive care unit and is inviting musical members of the Vanderbilt community to help.

Vanderbilt researchers studying the effect of music in the ICU include, from left, Miriam Ploger, MM, Ruth Kleinpell, PhD, Joseph Schlesinger, MD, Reyna Gordon, PhD, and Miriam Lense, PhD. (photo by Anne Rayner)

An interdisciplinary group of Vanderbilt researchers is launching a pilot study on the effect of live music on patients, families and staff in the adult intensive care unit (ICU) and is inviting musical members of the Vanderbilt community to help.

The study, Therapeutic Music in the Intensive Care Unit, calls for volunteer musicians — Vanderbilt students, staff and faculty — to play piano or flute in patients’ rooms in Vanderbilt University Medical Center’s adult ICUs. The impact of the music program will be assessed over a three-month pilot period with patients, family members and ICU clinical nursing and medical staff using established tools to assess anxiety, perceptions of benefit and strategies and barriers to implementation.

“It’s known that music can play an important role in intensive care medicine. It can mask noise levels from therapies like mechanical ventilators and physiologic alarms, blunt the known cardiovascular stresses of noise and promote patient and family relaxation during a difficult time,” said Ruth Kleinpell, PhD, assistant dean of Clinical Scholarship and professor of Nursing, who is co-directing the study. “Yet despite its well-known benefits, music therapy is rarely observed in daily practice in an ICU and there hasn’t been a lot of research regarding the impact of music in the ICU for patients, family members and clinicians.”

The pilot is a collaboration between faculty at Blair School of Music, the School of Nursing, Vanderbilt University Medical Center, the Department of Otolaryngology Music Cognition Lab and the Program for Music, Mind and Society.

“As an ICU doctor, I see my patients struggle to get better, but even as they get better, they can have neuropsychological outcomes like PTSD and delirium,” said Joseph Schlesinger, MD, associate professor of Anesthesiology and Biomedical Engineering. “There’s a lot of literature that shows that music might alleviate some of that. What we’re working to do is bring musicians into the ICU to try to improve patient outcomes, and at the same time help the staff who take care of these patients.”

Vanderbilt University undergraduates are encouraged to participate and investigate using the experience to develop their Immersion projects. Vanderbilt community musicians are asked to fill out an interest form and then participate in an initial one-hour orientation session.

The study will provide information that can help critical care practitioners develop best practices for designing, implementing and evaluating a patient- and family-focused music program in the ICU.

“Patients will be offered individual music sessions to be played by their bedsides. For patients unable to communicate their preferences, family or bedside staff will decide if it is conducive for the patient to receive a music therapy session,” Kleinpell said. “Bedside clinical nurses will assist in monitoring the patient’s response to the music in terms of changes in vital signs, restlessness, promotion of sleep or other signs of relaxation.”

The session will be stopped if there are observed changes in a patient’s vital signs or clinical status that may indicate an unfavorable response, such as increased heart rate or blood pressure, agitation or restlessness.

Kleinpell and Schlesinger hope the study leads to a formal music program in all VUMC ICUs. “Eventually, we’d like to have local musicians — this is Music City, after all — come into the hospital and play music in a therapeutic setting to try to help the patients, families and clinicians,” Schlesinger said. “As we go forward, we’d like to make it a standard of care in the ICU.”

Other participants include Marianne Ploger, BM, MM, associate professor of Music Perception and Cognition and director of the Musicianship Program, Blair School of Music; Reyna Gordon, PhD, assistant professor of Otolaryngology and Psychology and co-director, Music Cognition Lab, VUMC; Miriam Lense, PhD, assistant professor of Otolaryngology and co-director, Music Cognition Lab, VUMC; and Todd Rice, MD, MSc, associate professor of Medicine and director of the Medical ICU.

Nashville Piano Rescue has donated an upright piano on wheels to be used by the program; musicians will be asked to play from an established playlist of classical music previously evaluated as effective in hospital settings.

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