Study of noise levels in a neonatal intensive care unit

Abstract

The integrated care approach has been a focal point o f interest for the past few years. In this approach, noise is viewed as a compromising element in the normal development o f newborns in neonatal intensive care units. The objective o f this study was to develop a methodology that could evaluate the impact o f a training program designed for nurses regarding existing noise levels within a neonatal intensive unit. This method entails measurements o f noise levels and their sources. The method's development was based on a continuous evaluation of noise levels in a neonatal intensive care unit (NICU), using a computer (type 1 sound-level metre) before the nurses' training. In order to evaluate the impact of the nurses' training, noise level measurements obtained before training at described locations are to be repeated after training. LAeq, 1 sec, as well as audio samples were recorded throughout 8 work shifts. The project was conducted in an Ottawa regional hospital that specializes in the treatment of sick children. The average pre-training noise levels were 53 dBA, 61 dBA and 65 dBA, for the night, day, and evening shifts respectively. These levels largely exceed the maximum sound level o f 40 dBA recommended by the World Health Organization to avoid negative effects on sleep in hospitals. On the basis of this study, the training of nurses likely contributes to the reduction of noise levels in NICUs, but interventions concerning noise control are also necessary in order to ensure an acceptable sound environment for neonates requiring intensive care. (Project supported by the University of Ottawa) SOMMAIREAu cours des dernières années, l'approche de soins intégrés a retenu l'attention. Entre autres, le bruit est considéré comme un élément qui peut compromettre le développement normal des nouveau-nés dans les unités de soins intensifs (NICU). L'objectif de cette étude était de développer une méthodologie qui permettrait d'évaluer éventuellement l'impact d'une formation des infirmières sur les niveaux de bruit prévalant dans les unités de soins intensifs. La méthode porte sur les mesures de bruit et leur source. L'élaboration de la méthode a été basée sur une évaluation continue des niveaux de bruit dans un NICU, avant la formation des infirmières, en utilisant un ordinateur (sonomètre, classe 1). Dans le but d'évaluer l'impact d'une formation des infirmières, les mesures des niveaux de bruit obtenus avant la formation devront être reprises après la formation. Des LAeq, 1sec., ainsi que des échantillons audionumériques, ont été enregistrés lors de 8 périodes de travail. Le projet a été mené dans un hôpital pédiatrique de la région d'Ottawa. Les niveaux moyens de bruit pré-formation étaient de 53 dBA, 61 dBA et 65 dBA, pour la nuit, le jour et la soirée, respectivement. Ces niveaux dépassent largement le maximum de 40 dBA recommandé par l'Organisation Mondiale de la Santé afin d'éviter les effets négatifs sur le sommeil. Sur la base de cette étude, il est prévu que la formation des infirmières devrait con...

Noise measurement in NICUs and incubators with newborns: a systematic literature review

“…The most frequently used strategy to identify these sources was recording, in specific instruments, the points when impulsive noises were emitted and their respective sources with later association to the measured noise levels (17,24,28,30,32-34,37,40- should also be considered. This association was predominantly observed in Group A, between measured levels and days of the week or periods of the day (16,(19)(20)(21)(23)(24)27,30,(32)(33)(34)(37)(38) and between measured levels and different events (16,(19)(20)(21)24,(32)(33)(34)(37)(38) . Only two studies (50)(51) in Group B associated the measured levels with the days of the week or periods of the day.…”

“…All the studies described the measurement equipment and the most frequently used were Sound Pressure Level (SPL) measurers as recommended by NBR 10.151 (13) . More recent studies (23,27,31,33,37,44) also used computer systems with programs to acquire and process noise, which allows more time to capture the noise and more flexibility in analyzing it. The analysis of different sound frequencies motivated the use of octave bands (46)(47)(48) .…”

“…The Leq measure, strongly recommended, was used in 71% of the studies in Group A (16,(20)(21)(23)(24)(25)27,(29)(30)(31)(32)(33)(34)(36)(37)(38) and in 44% of Group B (41)(42)44,46,(49)(50)(51) . It is important to note that this type of measurement was more frequently observed from the 1990s on, perhaps due to the technological development of measurement equipment and the availability of PCs and software.…”

“…In Group A the following were identified: life support device alarms (17,22,24,(27)(28)(29)(30)32,(34)(35) ; conversation (19,(21)(22)(24)(25)28,30,32,34,37) ; handling of cupboards, drawers, bins and doors (24,(26)(27)30,32) ; falling objects (24,30) ; moving furniture and equipment (17,22,30) ; telephones (28,30) ; use of sinks (27) , and transit of professionals (17) . In Group B, in addition to the equipment alarms (40)(41)(42)44,48,(51)(52) and conversation (41,(43)(44)(49)(50)(51) , team activities near the incubators were also observed (41,(50)…”

Pre-Post Pilot Study of Noise Levels at a University Hospital Center Pharmacy Department

“…Measurements were taken in 13 different pharmacy work zones organized according to 2 functions: production (1-9) and administrative support (10)(11)(12)(13). Zone 1 was the zone for storing medications, zone 2 was used for bagging solid oral medications, zone 3 was the zone for entering prescriptions and preparing first doses, zone 4 was dedicated to restocking medication carts on a daily basis, zone 5 was used for the preparation and distribution of prescriptions for an external center, zone 6 was a positive pressure airlock, zone 7 was a positive pressure zone for compounding sterile medications, zone 8 was a zone for compounding nonsterile products in 2007, zone 9 was dedicated to compounding nonsterile products in 2012, zone 10 was the administrative support office of the management team and research unit, zone 11 was the clinical research support office, zone 12 was the pharmacists' office, and zone 13 was a pharmacotherapeutic information center.…”