Integrating Music Therapy and Nursing for Neonatal Procedural Support Using a Pacifier Activated Lullaby Device

Premature neonates may require hospitalization in the neonatal intensive care unit (NICU), where they receive life-sustaining medical treatment. Care often involves the need for painful, invasive medical procedures. Music therapists working with nurses in pediatric health care settings can provide procedural support to patients via therapeutic music interventions.

The purpose of this evidence-based practice pilot initiative was to examine the impact of a pacifier activated lullaby (PAL) device intervention, facilitated by a NICU music therapist (NICU-MT) in collaboration with bedside nurses, on neonates undergoing retinopathy of prematurity (ROP) exams in the NICU.

The NICU-MT facilitated the PAL device intervention for neonates (N = 25) following ROP exams. Data were collected before the procedure; at the end of the procedure; and at one, three, and five minutes of PAL device use. Measurements to assess infant pain and stress before, during, and after the procedure included vital signs and pain scores.

Findings reflected improvements in vital signs and pain scores following the five-minute PAL intervention, with measurements nearing preprocedure baseline averages, despite noteworthy end-of-procedure averages (including increased heart rate, decreased arterial oxygen saturation, and elevated pain scores). Outcomes from the pilot suggest that the PAL device may encourage a return to preprocedure baseline levels following ROP exams.

NICU-MTs and nurses can collaboratively provide procedural support using a therapeutic music intervention such as the PAL device to comfort neonates during painful, invasive procedures.