Targeted noise reduction observational study for reducing noise in a neonatal intensive care unit

Sanjay Chawla, M. Waihy, D. Kamat, S. Shankaran, B. Panaitescu, B. Wang, G. Natarajan, Paul Barach

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

BACKGROUND: Sleep is critical to patient recovery in the hospital, hospitalization is not restful, and inpatient sleep deprivation has been linked to poor outcomes. Excessive noise in neonatal intensive care units (NICUs) can interfere with infants' growth, development and healing. Sound levels in many NICUs exceed the recommended levels by the World Health Organization. METHODS: We implemented a unit-based nursing empowerment approach focused on noise reduction strategy in an urban, tertiary academic medical center NICU that included baseline noise measurements. We conducted a survey involving staff and visitors regarding their opinions and perceptions of noise levels in the NICU. Ongoing feedback to staff after each measurement cycle was provided to improve awareness, engagement and adherence with noise reduction strategies. After widespread discussion with active clinician involvement, consensus building and iterative testing, changes were implemented including: lowering of equipment alarm sounds, designated 'quiet times' and implementing a customized education program for staff. INTERVENTIONS: A multi-phase noise reduction quality improvement (QI) intervention to reduce ambient sound levels in a patient care room in our NICUs by 3 dB (20%) over 18 months. RESULTS: The noise in the NICU was reduced by 3 dB from baseline. Mean (s.d.) baseline, phase 2, 3 and 4 noise levels in the two NICUs were: LAeq: 57.0 (0.84), 56.8 (1.6), 55.3 (1.9) and 54.5 (2.6) dB, respectively (P o 0.01). Adherence with the planned process measure of 'quiet times' was >90%. CONCLUSIONS: We implementing a multi-pronged QI initiative resulted in significant noise level reduction in two multi-pod NICUs. It is feasible to reduce noise levels if QI interventions are coupled with active engagement of the clinical staff and following continuous process of improvement methods, measurements and protocols.

Original languageEnglish (US)
Title of host publicationProceedings of the 23rd International Congress on Acoustics
Subtitle of host publicationIntegrating 4th EAA Euroregio 2019
EditorsMartin Ochmann, Vorlander Michael, Janina Fels
PublisherInternational Commission for Acoustics (ICA)
Pages7825-7832
Number of pages8
ISBN (Electronic)9783939296157
DOIs
StatePublished - 2019
Externally publishedYes
Event23rd International Congress on Acoustics: Integrating 4th EAA Euroregio, ICA 2019 - Aachen, Germany
Duration: Sep 9 2019Sep 23 2019

Publication series

NameProceedings of the International Congress on Acoustics
Volume2019-September
ISSN (Print)2226-7808
ISSN (Electronic)2415-1599

Conference

Conference23rd International Congress on Acoustics: Integrating 4th EAA Euroregio, ICA 2019
CountryGermany
CityAachen
Period9/9/199/23/19

Keywords

  • Intensive care unit
  • Noise reduction
  • Quality improvement

ASJC Scopus subject areas

  • Mechanical Engineering
  • Acoustics and Ultrasonics

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