Is There Sufficient Training of Health Care Staff on Noise Reduction in Neonatal Intensive Care Units? a Pilot Study From Neonoise Project

Abstract

Evidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement and evaluate the effectiveness of a training program (TP) on noise reduction in a Neonatal Intensive Care Units (NICU) by comparing the noise levels before and after the implementation of the program. A total of 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and location of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly following implementation of the training program noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However a significant difference was found for Lp, Cpeak, before and after training staff, suggesting greater care by healthcare professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.

Assessment and characterization of sound pressure levels in Portuguese neonatal intensive care units

“…Kellam & Bhatia [34] suggested that human speech contribute to the spike in sound energy at 500 Hz. In addition, results described by Carvalhais et al [1] showed the same pattern. In fact, evidence shows a reduction in sound pressure levels predominantly above 400 Hz during the night, where there is a tendency to decrease conversation and alarm sounds [1,33].…”

“…In general, noise was identified by healthcare professionals as an agent with a negative impact on the environment. Indeed, other studies in hospital context found similar data [1,29,30]. However, in a study conducted in an emergency department, 53% of the sample (only constituted by nurses) felt their cognitive function was never or rarely affected by noise [31].…”

“…Mechanical devices, ventilation systems, as well as patients and staff are general sources within hospitals. In the particular case of NICU rooms and inside incubators, noise production is due to alarms produced by life support devices, flow of medical gas, communication among professionals and during activities of nursing care [1][2][3]. Additionally, ongoing exposure to alarms, noisy incubators and loud jarring sounds occur regularly in the NICU environment, putting premature infants at risk of noise induced hearing loss and other many health problems, such as sleep disorders and failure in cognitive activations [4,5].…”

Noise Reduction and Control in Hospital Environment: Design of the NeoNoise Project

“…Health professionals are aware about this issue and identified noise as an agent with a negative impact on work performance [6][7][8]. In fact, it is known that the hospital environment has many occupational health risks due to the variety of clinical and nonclinical tasks performed by healthcare workers.…”

“…To ensure that all the staff of the NICU under study such as physicians, nursing staff, and auxiliary staff attended the lecture (n = 79), 14 training sessions were given [2,6]. The lecture included (1) general concepts of noise; (2) the results of the sound pressure levels obtained in the first phase and the comparison of these to the recommended values suggested by WHO and other regulatory agencies; (3) the negative impact of noise on health, both for neonates and professionals; and (4) some actions that needed to be implemented to ensure noise reduction were undertaken [6]. Regarding these actions, health professionals had a significant role in the development of an action plan to address specific noise issues.…”