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Updated: Aug 9, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Sound level exposure of high-risk infants in different environmental conditions
Jacqueline F Byers1, W Randolph Waugh, Linda B Lowman
1School of Nursing, University of Central Florida, Orlando 32816-2210, USA. jbyers@mail.ucf.edu
Insights
Noise levels in neonatal intensive care units (NICUs) remain high despite renovations. Equipment, alarms, and staff activities significantly contribute to sound, impacting infant well-being and development.
Area of Science:
- Neonatal care
- Environmental acoustics
- Pediatric health
Background:
- Neonatal intensive care units (NICUs) present unique environmental challenges.
- Excessive noise is a significant stressor for high-risk infants.
Purpose of the Study:
- To measure sound levels in NICUs under various conditions.
- To assess the impact of physical renovations on NICU noise.
- To identify sources contributing to high sound levels in NICUs.
Main Methods:
- Descriptive and comparative study design.
- Convenience sampling of 134 infants in a tertiary children's hospital.
- Measurement of A-weighted decibel (dBA) sound levels in actual and simulated NICU environments.
Main Results:
- Renovated NICU spaces were 4-6 dBA quieter than non-renovated areas.
- Sound levels persisted above recommended guidelines despite renovations and staff training.
- Key contributors to noise included respiratory therapy equipment, alarms, staff conversations, and infant fussiness.
Conclusions:
- Physical renovations and staff training alone are insufficient to meet recommended NICU noise levels.
- Evidence-based strategies are needed for effective noise reduction.
- Findings inform environmental management and future NICU design for developmental, family-centered care.
Purposes:
To provide descriptive information about the sound levels to which high-risk infants are exposed in various actual environmental conditions in the NICU, including the impact of physical renovation on sound levels, and to assess the contributions of various types of equipment, alarms, and activities to sound levels in simulated conditions in the NICU.
Design:
Descriptive and comparative design.
Sample:
Convenience sample of 134 infants at a southeastern quarternary children's hospital.
Main Outcome Variable:
A-weighted decibel (dBA) sound levels under various actual and simulated environmental conditions.
Results:
The renovated NICU was, on average, 4-6 dBA quieter across all environmental conditions than a comparable nonrenovated room, representing a significant sound level reduction. Sound levels remained above consensus recommendations despite physical redesign and staff training. Respiratory therapy equipment, alarms, staff talking, and infant fussiness contributed to higher sound levels.
Conclusion:
Evidence-based sound-reducing strategies are proposed. Findings were used to plan environment management as part of a developmental, family-centered care, performance improvement program and in new NICU planning.
