Influence of Quiet Time on the Auditory Environment of Infants in the NICU

Zauche, Lauren Head; Zauche, Michael S.; Williams, Bryan L.

doi:10.1016/j.jogn.2020.09.159

Cited by 7 publications

(22 citation statements)

References 23 publications

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“…Moreover, previous research has shown that quiet time in hospitals, particularly in ICUs, provides many benefits, particularly in NICUs, where it is associated with more silence, fewer electronic sounds, and less talk than non-quiet time. Implementing quiet time decreases noise and exposure to electronic sounds in the NICU without sacrificing patient care [ 29 , 37 , 38 ]. Applebaum et al [ 39 ] found that most participants reported lower noise levels after quiet-time interventions.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Quiet Time on Psychological Outcomes of Neonatal Intensive Care Unit Nurses in Jeddah, Saudi Arabia: A Cross-Sectional Study

Ismail,

Imam,

Raguini

et al. 2023

Cureus

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Background and objective: Although quiet time is implemented in neonatal intensive care units (NICUs) for the benefit of infants, it may also positively impact the psychological outcomes of healthcare professionals. Several studies have examined the impact of quiet-time implementation on patients; however, there is a paucity of research assessing its impact on the psychological outcomes of NICU nurses, particularly in Saudi Arabia. Objective and methods: This study aimed to assess the impact of quiet time on the psychological outcomes (stress, anxiety, and depression) of NICU nurses in Jeddah, Saudi Arabia. A cross-sectional design was used for this study. A total of 87 NICU nurses from two hospitals participated in this study. One group did not practice quiet time, while the second group did. A questionnaire survey assessed participants’ demographic characteristics, and their depression, anxiety, and stress were assessed using the depression, anxiety, and stress scale-21 (DASS-21). The data were analyzed for frequency, percentage, mean, and standard deviation (SD). Bivariate analysis, independent t-tests, and one-way analysis of variance were used to test the differences between variables and groups. Pearson’s correlation coefficient ( r ) was used to analyze the relationships between continuous variables and perceived stress, anxiety, and depression. Results: A substantial number of NICU nurses perceived stress, anxiety, and depression; however, there were no significant differences in perceived stress, anxiety, and depression between the nurses who worked in NICUs that applied quiet time and NICUs that did not (P ≤ 0.05). Conclusion: This study found no statistically significant relationship between quiet-time implementation and perceived stress, anxiety, or depression among NICU nurses. Further research with a larger sample size or increased quiet-time implementation may be required.

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Section: Discussionmentioning

confidence: 99%

“…During quiet time, measures should be implemented, including limiting conversations, eliminating environmental noise, and dimming lights [8]. Implementing quiet time protocols in the NICU results in positive outcomes for patients and healthcare professionals [29][30][31]. Quiet time contributes to healthier workplace environments [30,31].…”

Section: Introductionmentioning

confidence: 99%

Impact of Quiet Time on Psychological Outcomes of Neonatal Intensive Care Unit Nurses in Jeddah, Saudi Arabia: A Cross-Sectional Study

Ismail,

Imam,

Raguini

et al. 2023

Cureus

View full text Add to dashboard Cite

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“…In the hospital setting, the census fluctuates and parents who received initial education were not present during the entire project. The PDSA (Plan-Do-Study-Act) method was utilized in the development and implementation of this pilot project 22…”

Section: Methodsmentioning

confidence: 99%

“…The PDSA (Plan-Do-Study-Act) method was utilized in the development and implementation of this pilot project. 22…”

Section: Project Overviewmentioning

confidence: 99%

A Quality Improvement Pilot Project for Noise Reduction in the NICU

Hull

Wright

2023

Advances in Neonatal Care

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The sounds that infants in utero are exposed to are muffled and dampened by amniotic fluid and the uterine wall. 1 This decrease in noise allows the infant brain to grow as needed, without interruption. 2 When a healthy term infant is born, the infant can process external stimuli without negative physiologic effects occurring. This is not the case for all infants. Premature and critically ill infants are at increased risk of negative effects related to noxious external stimuli, due to the activation of autonomic and hypothalamic-pituitary-adrenal stress systems. [1][2][3] Noise reduction in the neonatal intensive care unit (NICU) takes heightened awareness by the staff and is a critical aspect of neonatal care.The pod in which this project occurred was high acuity, which led to increased noise levels in the NICU, increased staff and parent stress levels, and decreased rest time for infants. A large portion of this specific neonate population required surgical intervention and increased rest to conserve energy for healing and growth. 3 Per the American Academy of Pediatrics (AAP), the recommended noise level should be less than 45 decibels (dBA). [3][4] The average baseline noise level was 62.6 dBA in a 24-hour period, which is 39% higher than the recommended noise levels (Figure 1). PROBLEMConstant high levels of noise in the NICU have been shown to cause detrimental neurological effects due to an increased stress response, especially for the very low birth-weight and extremely low birthweight population. 3,4 These potential effects include but are not limited to increased risk of hearing loss, periventricular hemorrhage, leukomalacia, developmental delay, disruption in the autonomic nervous system, and dysregulation of the infant's sleep cycle. [4][5][6]

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“…The "quiet time protocol" or "quiet hour protocol" intervention includes a specific period consisting of 8-hour shifts during which light and sound are controllably reduced, and irritations at the patient's bedside are minimized (24,25). A protocol is designed to improve the environment by focusing on minimizing sound by including private rooms, educating staff about the negative effects of sound, keeping staff quiet, minimizing patient handling, turning down the alarm sounds, or setting them to vibration mode, using visual warning systems, responding immediately to the warning, building a toilet away from the baby's bed, and using plastic drawers instead of metal drawers (26). In the quiet time protocol, it is important to identify the source of the patient's stress as an environmental stimulus, prevent environmental stressors, and increase adaptation to the environment.…”

Section: Introductionmentioning

confidence: 99%

Interventional Effect of Quiet Time Protocol on the Physiological Parameters of Premature Neonates Admitted to the Neonatal Intensive Care Unit

et al. 2023

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Background: Premature neonates are a group of high-risk patients who need intensive medical care and hospitalization in the neonatal intensive care unit (NICU) for their survival. In the NICU environment, there are highly stressful stimuli that have a negative effect on the physiological parameters of premature neonates. One of the interventions that improve the physiological parameters of neonates is the implementation of the quiet time protocol. Objectives: The present study aimed to investigate the effect of the quiet time protocol intervention on the physiological parameters of premature neonates admitted to the NICU. Methods: This quasi-experimental study was performed on 62 premature neonates selected through a convenient sampling method out of the neonates admitted to the NICU. First, the samples of the control group were collected. A demographic data questionnaire was employed. Neonates in the two groups were examined for 60 min during three phases before, during, and after the intervention in the evening shift of 15 - 17 o’clock. Data were analyzed using the SPSS software version 22 by the chi-squared test, repeated measures analysis of variance (ANOVA), and t-test. P-value < 0.05 was considered statistically significant. Results: The results of repeated measures ANOVA regarding arterial blood oxygen saturation (SaO2) percentage showed that changes over time were significant (P < 0.001). There was also a significant difference between the groups in terms of intervention effect (P = 0.004). In other words, the changes in SaO2 percentage were not the same in the two groups, and the changes in the score of the intervention group were higher than the control group. The results of repeated measures ANOVA showed that the changes in the heart rate and respiratory rate over time were significant (P < 0.001). Conclusions: The quiet time protocol is effective in reducing environmental stimuli and improving physiological parameters. Therefore, the implementation of these procedures during each 8-hour shift, which includes a specific period which light, sound, and bedside stimulation is controllably reduced, is recommended as a standard of care to reduce stress and improve the growth and development of premature neonates in the NICU.

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Influence of Quiet Time on the Auditory Environment of Infants in the NICU

Cited by 7 publications

References 23 publications

Impact of Quiet Time on Psychological Outcomes of Neonatal Intensive Care Unit Nurses in Jeddah, Saudi Arabia: A Cross-Sectional Study

Impact of Quiet Time on Psychological Outcomes of Neonatal Intensive Care Unit Nurses in Jeddah, Saudi Arabia: A Cross-Sectional Study

A Quality Improvement Pilot Project for Noise Reduction in the NICU

Interventional Effect of Quiet Time Protocol on the Physiological Parameters of Premature Neonates Admitted to the Neonatal Intensive Care Unit

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