Good Practices to Reduce Noise Levels in the Neonatal Intensive Care Unit

Carvalhais, Carlos; Silva, Manuela Vieira da; Xavier, Ana; Baptista, João Santos

doi:10.1007/978-3-030-14730-3_32

Cited by 8 publications

(12 citation statements)

References 19 publications

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“…Single-bed rooms and external monitoring stations yield less disruptive noises. 35,36 The medical devices' alarms are another category of noise generators in the ICU. Monitoring systems and ventilator alarms account for 80% of the so-called disruptive noises in the ICU; these devices produce short and high-intensity noises that disrupt patients' sleep.…”

Section: Discussionmentioning

confidence: 99%

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

Imbriaco,

Capitano,

Rocchi

et al. 2023

Nursing in Critical Care

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BackgroundNoise pollution in intensive care units is a relevant problem, associated with psychological and physiological consequences for patients and healthcare staff. Sources of noise pollution include medical equipment, alarms, communication tools, staff activities, and conversations.AimTo explore the cumulative effects of noise caused by an increasing number and type of medical devices in an intensive care setting on simulated patients with increasing clinical complexity. Secondly, to measure medical device alarms and nursing activities' sound levels, evaluating their role as potentially disruptive noises.Study DesignObservational simulation study (reported according to the STROBE checklist). Using an electronic sound meter, the sound levels of an intensive care room in seven simulated clinical scenarios were measured on a single day (09 March 2022), each featuring increasing numbers of devices, hypothetically corresponding to augmented patients' clinical complexity. Secondly, noise levels of medical device alarms and specific nursing activities performed at a distance of three meters from the sound meter were analysed.ResultsThe empty room's mean baseline noise level was 37.8 (±0.7) dBA; among the simulated scenarios, noise ranged between 45.3 (±1.0) and 53.5 (±1.5) dBA. Alarms ranged between 76.4 and 81.3 dBA, while nursing tasks (closing a drawer, opening a saline bag overwrap, or sterile packages) and speaking were all over 80 dBA. The noisiest activity was opening a sterile package (98 dBA).ConclusionAn increased number of medical devices, an expression of patients' higher clinical complexity, is not a significant cause of increased noise. Some specific nursing activities and conversations produce higher noise levels than medical devices and alarms. This study's findings suggest further research to assess the relationships between these factors and to encourage adequate noise reduction strategies.Relevance to Clinical PracticeExcessive noise level in the intensive care unit is a clinical issue that negatively affects patients' and healthcare providers' well‐being. The increase in baseline room noise from medical devices is generally limited. Typical nursing tasks and conversations produce higher noise levels than medical devices and alarms. These findings could be helpful to raise awareness among healthcare professionals to recognize noise sources. The noisiest components of the environment can be modified by staff behaviour, promoting noise reduction strategies and improving the critical care environment.

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Section: Discussionmentioning

confidence: 99%

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

Imbriaco,

Capitano,

Rocchi

et al. 2023

Nursing in Critical Care

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“…Under any circumstances, developing countries could be considered as a separate case. Based on the observations made inside the neonatology area of the Isidro Ayora Hospital, and reported studies [24], different criteria were considered to propose a noise mitigation program. Staff awareness, continuous education aiming at a cultural change of the staff, and establishment of good medical practices such as carrying out noise controls for decision making, are required.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of reported cases concluded that recorded noise levels exceed the suggested limits by the WHO, the United States Environmental Protection Agency (EPA), and American Academy of Pediatrics (AAP), and/or Ecuadorian environmental regulations such as the Uni ed Text of Secondary Environmental Legislation (TULSMA) [13], [21]. On average, the noise levels in these units can range from 50 to 75 dBA, sometimes they present peaks that exceed 100 dBA and some prolonged sounds remain in ranges of 70 to 80 dBA [14], [22]- [24].…”

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confidence: 99%

The need to implement noise reduction measurements in a neonatal intensive care unit in hospitals in low and middle-income countries – A case study

Pozo,

Donoso,

Ojeda

et al. 2023

Preprint

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Purpose Improving the neonatal intensive care unit (NICU) noise conditions in public hospitals is challenging, especially in low- and middle-income countries. The Isidro Ayora General Hospital in Loja-Ecuador does not fall out of this reality. Therefore, this case study evaluates the noise levels in a NICU of a public hospital and proposes a noise mitigation program based on the obtained results.Methods A descriptive, observational, and quantitative study was carried out to determine the A decibels to which newborns at two NICUs are exposed. An HD2010UC/A Class 1 integrating portable sound level meter was used to detect noise pollution. Data were recorded in 60 seconds intervals during 24 continuous hours for 7 days. The device was placed at the basic (NICU-B) and intensive-intermediate (NICU-IEI) units, considering height and wall proximity.Results In the NICU-B maximum and minimum values were 74.1 and 49.7 dBA; an equivalent daily noise level of 49.3 dBA was recorded. In the NICU-IEI, values were between 71.4 dBA and 47.9 dBA, and the equivalent daily noise level was 53.1 dBA. These results exceed the recommended levels by the World Health Organization (WHO) and the Ecuadorian Ministerial Agreement 097-A, Regulatory Annex 5.Conclusions Other studies evaluating noise levels in other public hospitals in Ecuador or low and middle-income countries are necessary to support these findings. Noise levels in neonatal rooms should be known to implement noise reduction measurements such as incubators with effective acoustic attenuation characteristics, earmuffs to be used on neonates, periodical strict noise controls, etc.

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“…The sources of noise that contribute the most to this aggressive environment are the staff voices and the alarms from medical devices such as respirators, monitors, pumps and other life support devices. The American Academy of Pediatrics (AAP) recommends that background noise level in neonatal units should be less than 45 dBA with transient sound to 65-70 dBA; The World Health Organisation (WHO) recommends levels below 30-35 dBA [16,17]. Once the design guidelines and recommendations have been implemented, the new results and (noise and light) measurements will be compared with the results compiled in Table 1.…”

Section: Objectives and Proceduresmentioning

confidence: 99%

Design Guidelines for Light and Noise Management in the Neonatal Intensive Care Unit

Sanz-Segura

Pérez

Ferrer-Duce

et al. 2020

Lecture Notes in Mechanical Engineering

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Neonatal Intensive Care Units (NICU) are environments with a high level of sensory stress. Medical advances and technology have contributed to increase the ratio of survival of premature infants but some devices and practices expose these babies to excessive noise and toxic sensory stimuli for which they are not prepared. This is related to an increase of neonatal morbidities, that are considered as minor sequelae, but that can greatly alter the life of the child and the family. Those responsible for hospital management and caregivers who want to take a step forward, need standards to guarantee the benefit of neonatal health and a proper physical and cognitive development of these babies. Design activity, from a Human-Centered Design approach (HCD), together with Developmental Centered Care (DC) contribute to identify and reduce adverse environmental conditions for newborns and premature infants. The purpose of this paper is to establish a method to provide design recommendations and good practice guidelines from evidence and especially from in-situ observations carried out in neonatal units by a multidisplinary team (i.e., nurses, NICU supervisors and designers). Thus, we identify proposals to reduce stress situations and obtain potential benefits in the development of the hospitalized infant through adaptation of the NICU macroenvironment (i.e. the reduction of light and noise).

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Good Practices to Reduce Noise Levels in the Neonatal Intensive Care Unit

Cited by 8 publications

References 19 publications

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

The need to implement noise reduction measurements in a neonatal intensive care unit in hospitals in low and middle-income countries – A case study

Design Guidelines for Light and Noise Management in the Neonatal Intensive Care Unit

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