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Annmarie Gennattasio1,2, Brigit Carter1,2, Diana Maffei1,2

  • 1Division of Neonatal-Perinatal Medicine, Cohens Children's Medical Center, Northwell Health, New York, New York(Drs Gennattasio, Maffei, Weinberger, and Boyar); and Duke University School of Nursing, Durham, North Carolina(Drs Gennattasio, Carter, and Turner).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|July 23, 2024
PubMed
Summary
This summary is machine-generated.

Implementing the HUSH (Healthy, Undisturbed Sleep for the Hospitalized Infant) strategy significantly reduced noise levels in neonatal intensive care units (NICUs). This initiative demonstrates a sustainable approach to improving the NICU environment for infant neurodevelopment.

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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.