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Updated: Jul 17, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A quality improvement study on noise reduction in a level 3 neonatal intensive care unit
Mélanie Forestier1, Laurence Caeymaex2,3, Fabrice Decobert2
1Neonatal Intensive Care Unit, CHI Créteil, Créteil, France. melanie.forestier@aphp.fr.
None:
In many neonatal intensive care units, newborns are exposed to many sounds, including alarms and human activity. Noise consistently exceeds recommendations, having a potential negative impact on newborns' development. This study aimed to evaluate the impact of multimodal interventions on noise reduction in a level 3 neonatal intensive care unit. This was a quality-improvement monocentric study, conducted from February 2022 to May 2023. Interventions included a multiprofessional reflection on ways to reduce noise, a staff training, and a modification of the alarms' thresholds. Noise was evaluated before and after intervention using the number of noise peaks ≥ 45 dB/day, and the number of alarms/patient/day. Peaks ≥ 45 dB/day significantly decreased by 48% from before to after intervention (mean number (SD) 396.4 (152.7) versus 204.8 (64.6), p < 0.001). The mean number of ≥ 50 dB/day decreased from 110.0 (57.9) to 48.8 (22.4). The number of alarms decreased peaks from 257 alarms/patient/day before intervention to 134 alarms/patient/day after intervention.
Conclusion:
A multimodal intervention focused on noise reduction was followed by a significant decrease in noise pollution in a level 3 NICU. Multicenter studies on the impact of interventions to reduce noise pollution on short- and long-term outcomes of preterm newborns are required to confirm these results.
Summary:
In neonatal intensive care units, sound environment remains above noise recommendations all around the world despite evidence showing that exceeding noises can have negative effects on both patients and staff. A multi-professional reflection on noise reduction, a staff training, and a modification of patients' alarms decreased noise pollution in a neonatal intensive care unit.
What Is Known:
• Noise levels in NICUs consistently exceed international recommendations, potentially harming the neurodevelopment of preterm infants and increasing staff stress.
What Is New:
• A multimodal approach (staff training, alarm threshold adjustment, and collective reflection) significantly reduced noise peaks over 45dB and the number of daily alarms per patient.
