Skip to main content
Log in

Noise Reduction Based on Training Intervention and Using Visual Signs in Neonatal Intensive Care Units (NICUs)

  • Technical Note
  • Published:
Acoustics Australia Aims and scope Submit manuscript

Abstract

Noise may cause hearing damage and delayed growth and development in newborns in neonatal intensive care units. Hence, it is necessary to reduce noise in these environments. Training and use of visual signs have been investigated as the interventional strategies with the aim of reducing noise level and exposure in neonatal intensive care units. This quasi-experimental study (before and after design) was conducted in the NICU of Birjand University of Medical Sciences Hospital (BUMSH NICU). According to ISO9612 standard, equivalent and maximum noise level in the NICU was measured by a calibrated sound level meter TES model 1358C at various stations during different shifts. Subsequently, the training and visual signs (flags and posters) were utilized as the interventions and SPSS version 18 was used for data analysis. The average equivalent and maximum noise level were calculated between 43.5–69.2 and 55.3–79.2 dBA, respectively, which is above the standards recommended by the American Academy of Pediatrics (AAP). Staff conversation, equipment and alarms were among the main sources of noise pollution. The equivalent noise level showed meaningful reduction before and after the interventions (personnel training and visual signs usage) at night. Noise in our NICU was greater than the recommended sound levels of 45 dBA. However, training and visual signs interventions seemed effective in reducing noise levels, particularly during the night shift. Since conversation was identified as the main noise source, future research is recommended to determine personality traits in healthcare professionals and promote a culture of silence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Basner, M., Babisch, W., Davis, A., Brink, M., Clark, C., Janssen, S., Stansfeld, S.: Auditory and non-auditory effects of noise on health. Lancet 383(9925), 1325–1332 (2014)

    Article  Google Scholar 

  2. Philbin, M.K., Evans, J.B.: Standards for the acoustic environment of the newborn ICU. J. Perinatol. 26, S27–S30 (2006)

    Article  Google Scholar 

  3. Wachman, E.M., Lahav, A.: The effects of noise on preterm infants in the NICU. Arch. Dis. Child. Fetal Neonatal Ed. 96, F305–F309 (2011)

    Article  Google Scholar 

  4. Harding, C., Levin, A., Crossley, S.-L., Murphy, R., van den Engel-Hoek, L.: Effects of early communication intervention on speech and communication skills of preterm infants in the neonatal intensive care unit (NICU): a systematic review. J. Neonatal Nurs. 25, 177–188 (2019)

    Article  Google Scholar 

  5. Kisilevsky, B.S., Hains, S.M.J., Brown, C.A., Lee, C.T., Cowperthwaite, B., Stutzman, S.S., Swansburg, M.L., Lee, K., Xie, X., Huang, H., Ye, H.H., Zhang, K., Wang, Z.: Fetal sensitivity to properties of maternal speech and language. Infant Behav. Dev. 32, 59–71 (2009)

    Article  Google Scholar 

  6. Darcy, A.E., Hancock, L.E., Ware, E.J.: A descriptive study of noise in the neonatal intensive care unit: ambient levels and perceptions of contributing factors. Adv. Neonatal Care 8, 165–175 (2008)

    Article  Google Scholar 

  7. Coston, A.D., Aune, C.: Reducing noise in the neonatal intensive care unit. Pediatrics 144, 154–154 (2019)

    Google Scholar 

  8. Gray, L., Philbin, M.K.: Effects of the neonatal intensive care unit on auditory attention and distraction. Clin. Perinatol. 31(2), 243–260 (2004)

    Article  Google Scholar 

  9. Mcmahon, E., Wintermark, P., Lahav, A.: Auditory brain development in premature infants: the importance of early experience. Ann. N. Y. Acad. Sci. 1252, 17–24 (2012)

    Article  Google Scholar 

  10. White, R.D., Smith, J.A., Shepley, M.M.: Recommended standards for newborn ICU design. J. Perinatol. 33(Suppl 1), S2–S16 (2013)

    Article  Google Scholar 

  11. Smith, S.W., Ortmann, A.J., Clark, W.W.: Noise in the neonatal intensive care unit: a new approach to examining acoustic events. Noise Heal. 20, 121–130 (2018)

    Google Scholar 

  12. Aurélio, F.S., Tochetto, T.M.: Ruído em uma Unidade de Terapia Intensiva Neonatal: mensuração e percepção de profissionais e pais. Rev. Paul. Pediatr. 28, 162–169 (2010)

    Article  Google Scholar 

  13. Santos, B., Calado Orsi, K., Balieiro, M., Sato, M., Kakehashi, T., Pinheiro, E.: Effect of “quiet time” to reduce noise at the neonatal intensive care unit. Escola Anna Nery. 19(1), 102–106 (2015)

    Article  Google Scholar 

  14. Joshi, G., Tada, N.: Analysis of noise level in neonatal intensive care unit and post natal ward of a tertiary care hospital in an urban city. Int. J. Contemp. Pediatr. 3(4), 1358–1361 (2016)

    Article  Google Scholar 

  15. Szymczak, S.E., Shellhaas, R.A.: Impact of NICU design on environmental noise. J. Neonatal Nurs. 20, 77–81 (2014)

    Article  Google Scholar 

  16. Ramm, K., Mannix, T., Parry, Y., Gaffney, M.P.: (Caroline): a comparison of sound levels in open plan versus pods in a neonatal intensive care unit. HERD Heal. Environ. Res. Des. J. 10, 30–39 (2017)

    Article  Google Scholar 

  17. Nathan, L.M., Tuomi, S.K., Müller, A.M.: Noise levels in a neonatal intensive care unit in the Cape metropole. South Afr. J. Child Health 2(2), 50–54 (2008)

    Google Scholar 

  18. Milette, I.: Decreasing noise level in our NICU: the impact of a noise awareness educational program. Adv. Neonatal Care. 10(6), 343–351 (2010)

    Article  Google Scholar 

  19. ISO 9612-Acoustics. Determination of occupational noise exposure, engineering method (2009). https://www.iso.org/standard/41718.html

  20. Carvalhais, C., Santos, J., Da Silva, M.V., Xavier, A.: Is there sufficient training of health care staff on noise reduction in neonatal intensive care units? A pilot study from neonoise project. J. Toxicol. Environ. Health A 78(13–14), 897–903 (2015)

    Article  Google Scholar 

  21. Valizadeh, S., Bagher Hosseini, M., Alavi, N., Asadollahi, M., Kashefimehr, S.: Assessment of sound levels in a neonatal intensive care unit in Tabriz, Iran. J. Caring Sci. 2, 19–26 (2013)

    Google Scholar 

  22. Santos, J., Carvalhais, C., Xavier, A., Silva, M.V.: Assessment and characterization of sound pressure levels in Portuguese neonatal intensive care units. Arch. Environ. Occup. Heal. 73, 121–127 (2018)

    Article  Google Scholar 

  23. Casavant, S.G., Bernier, K., Andrews, S., Bourgoin, A.: Noise in the neonatal intensive care unit: what does the evidence tell us? Adv. Neonatal Care. 17, 265–273 (2017)

    Article  Google Scholar 

  24. Krueger, C., Schue, S., Parker, L.: Neonatal intensive care unit sound levels before and after structural reconstruction. MCN Am. J. Matern. Nurs. 32, 358–362 (2007)

    Article  Google Scholar 

  25. Chawla, S., Barach, P., Dwaihy, M., Kamat, D., Shankaran, S., Panaitescu, B., Wang, B., Natarajan, G.: A targeted noise reduction observational study for reducing noise in a neonatal intensive unit. J. Perinatol. 37(9), 1060–1064 (2017)

    Article  Google Scholar 

  26. Wang, D., Aubertin, C., Barrowman, N., Moreau, K., Dunn, S., Harrold, J.: Examining the effects of a targeted noise reduction program in a neonatal intensive care unit. Arch. Dis. Child. Fetal Neonatal Ed. 99(3), F203–F208 (2014)

    Article  Google Scholar 

  27. Calikusu Incekar, M., Balci, S.: The effect of training on noise reduction in neonatal intensive care units. J. Spec. Pediatr. Nurs. 22(3), e12181 (2017)

    Article  Google Scholar 

  28. Nogueira, MdFH, Di Piero, K.C., Ramos, E.G., de Souza, M.N., Dutra, M.V.P.: Noise measurement in NICUs and incubators with newborns: a systematic literature review. Rev. Lat. Am. Enfermagem. 19, 212–221 (2011)

    Article  Google Scholar 

  29. Elander, G., Hellström, G.: Reduction of noise levels in intensive care units for infants: evaluation of an intervention program. Heart Lung 24(5), 376–379 (1995)

    Article  Google Scholar 

  30. Matook, S.A., Sullivan, M.C., Salisbury, A., Miller, R.J., Lester, B.M.: Variations of NICU sound by location and time of day. Neonatal Netw. 29, 87–95 (2010)

    Article  Google Scholar 

  31. Bhat, L., Bisht, S.: Effect of educational intervention among NICU team and parents in reducing sound level in neonatal ICU. J. Neonatal Biol. 5(4), 1–3 (2016)

    Article  Google Scholar 

  32. Lahav, A.: Questionable sound exposure outside of the womb: frequency analysis of environmental noise in the neonatal intensive care unit. Acta Paediatr. Int. J. Paediatr. 104, e14–e19 (2015)

    Article  Google Scholar 

  33. Almadhoob, A., Ohlsson, A.: Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants. Cochrane Database Syst. Rev. 1. Art. No. CD010333 (2015)

Download references

Acknowledgements

The authors would like to thank the officials and those dear ones who provided their best cooperation in the project.

Funding

This work was supported by Birjand University of Medical Sciences (Project No. 874) (IR.BUMS.REC.1395.235).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vahideh Abolhasannejad.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Faal, G., Davoudi, A., Taheri, F. et al. Noise Reduction Based on Training Intervention and Using Visual Signs in Neonatal Intensive Care Units (NICUs). Acoust Aust 48, 309–314 (2020). https://doi.org/10.1007/s40857-020-00184-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40857-020-00184-4

Keywords

Navigation