BACKGROUND: Adult intensive care units (ICUs) generate a persistent acoustic burden from alarms, care activity, equipment and communication. This burden can undermine patient rest and contribute to alarm fatigue, cognitive workload and distress among nurses. AIM: To present a nursing-led conceptual framework for addressing alarm-related acoustic burden in adult critical care. STUDY DESIGN: Literature-informed conceptual analysis. A structured purposive evidence map was audited using two PubMed searches run on 9 September 2026 (3377 unique records after PMID deduplication) and citation checking. Twenty-nine selected sources were charted against the five domains. This was not a systematic review; no original data, formal consensus or framework validation was undertaken. RESULTS: QUIET Care proposes five connected practice domains: quantify and qualify the sound environment; use patient-specific monitoring and alarms; integrate quiet into workflow; engage people and culture; and track, test and learn. It treats the domains as locally adaptable hypotheses and requires explicit safety balancing measures. CONCLUSIONS: QUIET Care is a pragmatic proposal for local co-design and evaluation, not a validated intervention or universal sound target. RELEVANCE TO CLINICAL PRACTICE: The framework may help critical care nurses and leaders organise source mapping, alarm customisation, workflow redesign, team ownership and small safety-monitored tests of change while preserving the audibility of urgent alerts.
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Alsharari et al. (2026) studied this question.
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