Does noise on my neonatal unit matter? Exploratory cross-sectional multiple cohort professional opinion survey study

To examine how neonatal staff perceive the clinical impact of noise, including its influence on their performance and its potential contribution to neonatal morbidity.

A 56-item survey was developed, piloted and disseminated across all nine neonatal units in Wales, UK. Distribution was supported by unit-based study champions and weekly response monitoring. Responses were analysed using descriptive and inferential statistics, as well as inductive thematic analysis.

A total of 405 valid responses were received from clinical staff, including 260 nurses, 126 doctors and 19 allied health professionals, representing 49.6% of all neonatal nurses and doctors in Wales. Respondents spanned all levels of seniority and unit types.

Primary outcomes were the proportion of staff who perceived noise as having (1) a direct negative impact on neonatal health and (2) an indirect impact via impaired staff performance. Secondary outcomes included specific perceived clinical consequences (e.g., sepsis, intraventricular haemorrhage, necrotising enterocolitis) and the prevalence of noise-mitigation strategies in practice.

92% of staff reported that noise directly affects neonatal health; 76% believed that it indirectly contributes to harm through its impact on staff functioning. Nearly half of doctors and over one-third of nurses linked this to serious complications. Free-text responses revealed themes of concern over clinical harm, impaired communication and lack of effective institutional response.

Neonatal professionals view noise as a clinically significant risk factor. These findings support the need for system-level noise-reduction strategies and further evaluation through multicentre interventional studies aimed at reducing neonatal morbidity.