Noise: the importance of silencing the loud NICU

Abstract

In utero, the growing fetus is subject to low-frequency noises. However, the high-risk neonate experiences much harsher sounds in the extrauterine environment. Despite many advances, modern Neonatal Intensive Care units cannot mimic the womb environment for preterm infants. Neonates are exposed to a stressful noisy environment where sleep is frequently interrupted and physiologic consequences alter development. Undesirable noise can be generated from simple conversation, use of equipment, overhead announcements, surrounding objects, and vibration. Noise levels above the American Academy of Pediatrics (AAP) recommendation (under 35–45 decibels [dB]) are associated with adverse outcomes and hearing loss. Noise level in the NICU is an important patient safety issue and should be regularly addressed by healthcare providers. Understanding modifiable and non-modifiable noise can influence daily practices, NICU design, staff education, and unit-specific quality improvement programs.