The impact of a noise reduction quality improvement project upon sound levels in the open-unit-design neonatal intensive care unit

Abstract

Result: Implementation of a coordinated program of noise reduction strategies did not result in any measurable improvement in levels of loudness or quiet.Conclusion: Two centers, using primarily human behavior noise reduction strategies, were unable to demonstrate measurable improvements in sound levels within the occupied open-unit-design neonatal intensive care unit.

Comparing sound measurements in the single-family room with open-unit design neonatal intensive care unit: the impact of equipment noise

“…Philbin 15,17 suggested that human behavior change might be necessary, but not sufficient to achieve a quieter NICU environment, and a primarily human behavior strategy, within an OU NICU, to decrease sound levels, was found to be ineffective. Stevens 16 demonstrated the acoustic benefits of SFR design in the unoccupied NICU.…”

“…However, the use of common NICU equipment is a noise variable that may remain significant despite the above improvements. [15][16][17] Our goal was to compare sound level measurements within an OU level 3 NICU with the SFR level 3 NICU, accounting for the use of common NICU equipment.…”

“…During this time period, 28 discrete 24-h measurements were obtained in the level 3 bedside location. 17 The OU design unit included two large open bay areas with about 6 to 9 beds in each bay, and about 60 ft 2 per patient bedside area, with vinyl flooring and suspended ceiling with NRC 0.55, low-level acoustic ceiling tile. During this study period, level 3 patients required cardiopulmonary and generally pulse oximetry monitoring.…”

“…17 In the OU NICU level 3 bedside, the dosimeter was placed near the infant head area, either with the microphone suspended about 8 to 12 inches above the infant's head, or suspended from an adjacent intravenous fluid stand. Care was taken to avoid direct contact of the dosimeter or microphone with sources of excessive vibration, as associated with use of HFV.…”

“…[3][4][5][6][7] Published sound measurements in open-unit (OU) design NICU's appear to be excessive and do not comply with recommended levels. [8][9][10][11][12][13][14][15][16][17] Human behavior strategies have not been shown to be effective, 17 and unit design modifications have been suggested to be necessary to move toward significant improvements in measured NICU sound levels. 11,15 -17 This belief has coincided with a shift in new NICU construction away from the traditional OU design to NICU's with greater attention to acoustically favorable materials, and variable lay-outs, most notably, the single-family room (SFR) design.…”