Reducing Noise in the NICU.

Area of Science:

• Neonatal Intensive Care Unit (NICU) environment
• Pediatric Neurodevelopment
• Sleep Science in Infants

Background:

• Elevated noise in NICUs adversely affects infant neurodevelopment, sleep, and brain development.
• The American Academy of Pediatrics recommends NICU noise levels not exceed 45 dB.

Purpose of the Study:

• To decrease average NICU noise levels by 10% from baseline.
• To reduce exposure to severe noise (>65 dB) to less than 5% of the time.

Main Methods:

• A pre/post observational quality improvement project in a Level IV NICU (2021-2022).
• Interventions included staff/parent education, visual cues, technical equipment upgrades, and HUSH (Healthy, Undisturbed Sleep for the Hospitalized Infant) quiet times.
• Sound levels were monitored 20-24 hours/day, 5 days/week.

Main Results:

• Staff education and technical improvements reduced median noise in the stepdown unit (P < .001) but not the acute care NICU.
• The HUSH strategy's enforced 2-hour quiet times effectively reduced median noise and severe noise (>65 dB) in both NICU areas.

Conclusions:

• The HUSH strategy offers a sustainable method for reducing NICU noise.
• Future efforts should focus on education and dedicated quiet times to meet recommended standards.
• Further research is needed on the long-term developmental impacts of excessive noise on neonates.