Michael Voorhees, RNC, MS, executive director at East Mountain Hospital in Belle Mead, N.J., conducted a complementary treatment study to examine if the use of light, instrumental music made a difference in the use of PRN medications. After about a year and a half, Voorhees study results showed music had a calming effect on the environment, and patients decreased the use of PRN medications for anxiety, pain, psychosis and sleep by about 30%.
“The majority of our patients we treat have the primary diagnosis of schizophrenia and they come to us because of a crisis situation — for example, attempted suicide or a psychotic episode — and they may be voluntarily or involuntarily admitted to our facility,” Voorhees said.
East Mountain Hospital is a short-term New Jersey Department of Health-licensed inpatient facility that treats clients between age 19 and 64 who have long-term mental illness. The average length of stay is 13 days.
After patients are discharged from East Mountain, they may return to an outpatient program or participate in an outpatient day hospital program. With 16 beds in the facility, EMH resides on the grounds of Carrier Clinic, a private, 260-bed psychiatric facility.
“When I worked with patients with mental illness at other treatment settings, I noticed that an overwhelming number referred to music as an alternative coping strategy in times of stress,” Voorhees said. “Because East Mountain Hospital is a small hospital, I decided it was an opportunity for me to test this coping strategy.”
Voorhees reviewed and logged all PRN medications taken by patients to identify when peak use occurred. Based on his findings, Voorhees introduced the music during the three peak-use time periods of 8 to 10 a.m., 3 to 5 p.m. and 9 p.m. to 1 a.m.
Voorhees and staff conducted the study in four, 18-week segments. During the first and third segments, quiet instrumental music was piped into the unit. During the second and fourth segments, it was not. Voorhees calculated the number of PRN medications used during the music intervention weeks and compared it to times with no music intervention.Michael Voorhees, RN
During the weeks of music intervention, the music was playing for a total of eight hours. For the remainder of the day and during nonstudy weeks, any type of music was played as requested.
“Although our patients did not know about the music study, a majority of our patients had positive things to say about the music being played,” said Debbie Charette, RN-BC, director of nursing at EMH.
Voorhees hopes to expand the time periods the instrumental music is played and to offer CDs to clients when they are discharged from the unit. He also hopes to direct the study toward patients with one diagnosis, such as schizophrenia.
“Perhaps patients could make their own selections and choose when to listen to the music, which would make it a more individualized experience and hopefully result in more positive outcomes,” Charette said.