Authors (including presenting author) :
Ho LP (1), Ho PF (1), Ip WY (1), Leung HW (1), Leung ST (1), Yeung KY(1), Cheng SM (1)
Affiliation :
(1)Department of Paediatrics, Prince of Wales Hospital
Introduction :
Infants in NICU are constantly exposed to ambient noise that often exceeds recommended levels. American Academy of Pediatrics proposed that noise levels should not exceed 45 dB in NICU. Premature Infants are particularly vulnerable to elevated noise levels due to their immature auditory pathway. Many studies showed that such excessive noise will lead to many adverse health consequences. Loud and sharp noises not only induce physiological changes in heart rate, respiratory rate, oxygen saturation and increased apneic episodes, but also affects long-term growth and neurodevelopment in infants. However, we noticed that the noise level in our NICU has exceeded the recommended level, ranging from 52 to 79 dB. The noisy environment further leads to elevated volumes of conversations and alarms of monitors, affecting staff health. Although some loud noise in the NICU is unavoidable, some strategies were implemented to reduce the noise levels in our busy NICU.
Objectives :
The aim of this program is to effectively reduce noise level in our NICU, to promote both patient and staff health.
The objectives are: 1. to explore the sources of excessive loud noise in our NICU, 2. to implement strategies to alleviate noise sources, and 3. to enhance staff awareness on the maintenance of a quiet environment through continuous monitoring of the sound level and staff behavior change.
Methodology :
First, we performed literature review on the evidence of noise sources in both local and oversea NICU. Second, we used questionnaires to survey staffs’ perception on sources of noise in our local NICU. Third, we arranged different briefings and training sessions to raise staff awareness on the impact of loud noise. Fourth, we implemented strategies including changing the wheels of all noise trolley, padding of all rubbish bins, and putting insulated gel at the top of incubator, etc. to reduce noise. Fifth, we used posters to remind staff to follow our recommendations. Finally, we set up daily quiet periods and provided music therapy during these periods. To monitor the effectiveness, we used “Ear Monitor” for continuous monitoring of sound levels in NICU, the staff compliance, as well as their behavior change. We performed pre and post measurement for the actual ambient noise level before and after the program. Data and results were analyzed and compared in order to test for the effectiveness of this program.
Result & Outcome :
The mean ambient noise level within NICU was significantly reduced from baseline measurements by 9% in the span of a year. There were also reductions in noise levels of most individual items, ranging from 0.3 db to a maximum of 19.7 db after implementation of different strategies. The result showed the successfulness of this program. The aim and objectives were all achieved. Furthermore, after the introduction of this program, all staff had increased awareness and alertness in maintaining a quiet environment in our NICU. Staff’s behavior was kept on continuous monitoring currently and the program was sustaining.
