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Observational Study
. 2024 Aug 1;24(4):333-341.
doi: 10.1097/ANC.0000000000001179. Epub 2024 Jul 24.

Reducing Noise in the NICU

Annmarie Gennattasio  1   2 , Brigit Carter  1   2 , Diana Maffei  1   2 , Barbara Turner  1   2 , Barry Weinberger  1   2 , Vitaliya Boyar  1   2
Affiliations
Observational Study

Reducing Noise in the NICU

Annmarie Gennattasio et al. Adv Neonatal Care. .

Abstract

Background: In the neonatal intensive care unit (NICU), elevated noise negatively impacts the neurodevelopmental environment, interrupts sleep, and can affect brain development in neonates. The American Academy of Pediatrics recommends that noise levels in the NICU should not exceed 45 dB.

Purpose: The project aims were to: (1) decrease average noise level by 10% from baseline and (2) decrease exposure to severe noise (>65 dB) to <5% of the time.

Methods: This quality improvement project was conducted during 2021-2022 as a pre/post observational design in a Level IV NICU in New York City. We monitored sound levels for 20-24 h, 5 d/wk. Quality improvement interventions included: novel approaches to staff education, visual cues for when noise thresholds were exceeded, parent education, including access to personal decibel meters, technical improvements to vital sign monitors and entry doors, and defined quiet times (HUSH) for 2 h each 12-hour shift.

Results: Education efforts and technical improvements successfully reduced median noise levels within the stepdown unit ( P < .001), though not in the acute care NICU. In contrast, the implementation of 2-hour periods of enforced "quiet time" every 12 h effectively reduced both median noise levels and the incidence of severe noise (>65 dB) in both locations.

Implications for practice and research: The HUSH strategy may be a sustainable way to decrease noise in the NICU. Future projects should prioritize education and dedicated quiet times to align with recommended standards, while research should explore the long-term developmental impacts of excessive noise levels on neonatal growth.

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Conflict of interest statement

The authors declare no conflict of interest and no relevant financial interest or affiliation with any commercial interests related to the subjects discussed within this article. No grant or financial support for the implementation of this project. The authors declare no conflicts of interest.

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