Noise Reduction in the Neonatal Intensive Care Unit: A Quality Improvement Initiative

Ahamed, Mohamed Farooq; Campbell, Deborah E.; Horan, Susan; Rosen, Ora M.

doi:10.1177/1062860617711563

Cited by 35 publications

(49 citation statements)

References 33 publications

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“…Multiple strategies have been employed to reduce excessive sound exposure in the NICU, including staff education, introduction of quiet hours, and noise monitoring devices. 7,8,30 Incorporating acoustic foam in NICU construction resulted in an average 3.27 dB decrease in noise levels. 31 Despite the effective reduction in sound exposure with new construction of SFR NICUs with vibratory absorbing tile and other sound dampening design elements, 30 as were used in both the hybrid and SFR NICUs in this study, only rarely have the AAP recommended levels been achieved.…”

Section: Discussionmentioning

confidence: 99%

“…6 However, despite quality improvement initiatives, the AAP recommended levels are difficult to attain. [7][8][9] Modern NICU design incorporates acoustical architectural design elements to reduce sound exposure. Single family rooms (SFR) and open-pod rooms are quieter than open bay rooms, 10,11 but the impact of patient acuity and the relative contribution of individual environmental factors has not been well studied.…”

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Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application

et al. 2020

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Objective This study aimed to determine the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures. We hypothesized that monitoring with a smartphone application would identify modifiable environmental factors in different NICU design formats. Study Design Minimum, maximum, and peak decibel (dB) recordings were obtained using the Decibel X phone app, and the presence of noise sources was recorded in each patient space at three NICUs over a 6-month period (December 2017 to May 2018). Data were analyzed by Student's t-test and ANOVA with Bonferroni correction. Data were collected at the University of Maryland Medical Center single family room (SFR) level IV and St. Agnes Healthcare hybrid pod/single family room level III NICU, Baltimore, MD and at Prince George's Hospital Center open-pod design Level III NICU, Cheverly, MD. Results All recordings in the three NICUs exceeded the American Academy of Pediatrics (AAP) recommended <45 dB level. The maximum and peak dB were highest in the open pod format level III NICU. Conversations/music alone and combined with other factors contributed to increased sound exposure. Sound exposure varied by day/night shift, with higher day exposures at the level III hybrid and open pod NICUs and higher night exposures at the level IV SFR NICU. Conclusion Although sound exposure varied by NICU design, all recordings exceeded the AAP recommendation due, in part, to potentially modifiable environmental factors. A smartphone application may be useful for auditing NICU sound exposure in quality improvements efforts to minimize environmental sound exposure. Key Points

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Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application

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“…Na tentativa de minimizar os níveis de ruído nas unidades neonatais, alguns pesquisadores propuseram estratégias diferentes (8)(9)(10) .…”

Section: Introductionunclassified

“Horário do Soninho”: uma estratégia para reduzir os níveis de pressão sonora em uma unidade de terapia intensiva neonatal

Rocha

Sá

Reis

et al. 2020

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ResumoIntrodução: Estudos mostram que o ambiente muito estimulante, com altos níveis sonoros, interfere negativamente no desenvolvimento e crescimento de recém-nascidos. Objetivo: verificar se o "horário do soninho" é capaz de reduzir os níveis de pressão sonora em uma unidade de cuidados neonatais. Método: Trata-se de uma pesquisa transversal. A medida do nível de pressão sonora foi realizada durante 15 dias não consecutivos, com tempo de avaliação de 30 minutos antes, 1 hora durante e 30 minutos após o "horário do soninho" Resultado: Observamos uma redução dos níveis de pressão sonora durante o "horário do soninho" (p = 0,00). Essa redução permaneceu no período dos 30 minutos subsequentes, com diferença estatisticamente significante quando comparada ao período antes do "horário do soninho" (p = 0,00). Conclusão: O "horário do soninho" é uma ferramenta capaz de reduzir o nível de pressão sonora em uma unidade de terapia intensiva neonatalPalavras-Chave: ruído; Terapia Intensiva neonatal; Recém-nascido AbstractBackground: Studies show that super stimulating environment, with high sound levels, that negatively interfere in the development and growthof newborns. Aim: Verify if the "quiet time" is able to reduce the sound pressure levels in a neonatal care unit. Method: It is a cross-sectional research. The measurement of the sound pressure level was performed during 15 non-consecutive days with an evaluation time of 30 minutes before, 1 hour during and 30 minutes after the "quiet time" Result: We observed a reduction of the sound pressure levels during the hours of quiet time (p = 0.00). This reduction remained in the period of the subsequent 30 minutes, with a statistically significant difference when compared to the period before sleep time (p = 0.00). Conclusion: The “quiet time is a tool capable of reducing sound pressure level in a neonatal intensive care unitKey Words: noise; Intensive Care, neonatal; Infant, newborn Resumen"Tiempo de silencio": una herramienta para reducir los niveles de presión acústica en una unidad de cuidados intensivos neonatalesAntecedentes: los estudios muestran que el entorno súper estimulante, con altos niveles de sonido, interfiere negativamente en el desarrollo y crecimiento de los recién nacidos. Objetivo: Verificar si el "tiempo de silencio" puede reducir los niveles de presión acústica en una unidad de cuidados neonatales. Método: es una investigación transversal. La medición del nivel de presión sonora se realizó durante 15 días no consecutivos con un tiempo de evaluación de 30 minutos antes, 1 hora durante y 30 minutos después del "tiempo de silencio" Resultado: Observamos una reducción de los niveles de presión sonora durante las horas de tiempo de silencio (p = 0.00). Esta reducción se mantuvo en el período de los siguientes 30 minutos, con una diferencia estadísticamente significativa en comparación con el período anterior al tiempo de sueño (p = 0,00). Conclusión: el “tiempo de silencio es una herramienta capaz de reducir el nivel de presión acústica en una unidad de cuidados intensivos neonatales Palabras clave: ruido; Cuidados Intensivos, neonatales; Infante, recién nacido

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“…The average temporal patterns of sound pressure (L Aeq ) levels during the morning (7:02-11:52), visiting (16:02-19:02) and night (23:02-7:02) periods for all the wards were provided in Table4. The rationale is to determine the duration of the day with high noise level to aid in future planning and development of noise mitigation policies in hospitals in Oman, including schools, and other social environments as well(Ahamed et al, 2017;Mazer, 2012). Among all the wards, the highest noise (L Aeq ) level was observed in EMW (60.65 dB (A)) during morning hours, while in visiting hours FMW was found to have the highest noise level of 62.4 dB(A).…”

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Spatiotemporal Assessment Of The Effect of Indoor Noise On Annoyance, Health And Comfort In Hospital Wards And Intensive Care Unit

Amoatey¹,

Al-Harthy²,

Ma³

et al. 2021

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Hospital-noise levels can induce physiological responses, and affects sleep quality, which could contribute to cardiovascular-related health problems. Till date, high resolution hospital noise exposure assessment studies have not received much attention in Oman. This study aims at assessing sound pressure levels across hospital wards and intensive care unit (ICU) rooms to determine annoyance, and potential health effects based on perception and risk estimates. An indoor exposure assessment using high precision noise sensors was conducted in a female medical ward (FMW), isolated ward (SLW), emergency ward (EMW), and intensive care Unit (ICU) in a public hospital in Muscat city, Oman. Self–administered questionnaire was randomly distributed among respondents using both online and field survey approach to ascertain annoyance, health effects, and potential risks associated with exposure. The study found that 24–hr noise levels (LAeq) ranged from 55.2–61.7 dB(A) in the hospital wards and ICU rooms, which exceeded WHO’s hospital indoor rooms critical limit of 35 dB(A) by 58% – 76%. A total of 150 participants took part in the survey. Among the respondents, 53% reported moderate annoyance at the hospital wards while 56% felt sensitivity to the noise levels. Noise annoyance was reported by the majority of the patients across the various wards and emergency rooms as causing slight annoyance (50%) and intermittent sleep disturbances (49%). The majority (73%) of the medical staff have complained that the current noise levels affect overall work performance (p = 0.004), while 70% of them have further complained of it as a cause of workplace distraction (p = 0.011). Quantitative risk estimates showed that both the % of highly annoyed (HA) persons (16%), and highly sleep–disturbed (HSD) persons (9%) were very high in FMW, while ICU was found to have the lowest risk. However, the greater number of the respondents (87%) believed there are possibilities of mitigating (p <0.001) the current noise levels.

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Noise Reduction in the Neonatal Intensive Care Unit: A Quality Improvement Initiative

Cited by 35 publications

References 33 publications

Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application

Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application

“Horário do Soninho”: uma estratégia para reduzir os níveis de pressão sonora em uma unidade de terapia intensiva neonatal

Spatiotemporal Assessment Of The Effect of Indoor Noise On Annoyance, Health And Comfort In Hospital Wards And Intensive Care Unit

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