The sound is among the most all-encompassing stimuli in NICU

The Sound in the NICU

The sound is one of the most pervasive stimuli in the NICU. The safe sound is critical for premature newborns’ good growth. It is estimated that 12.7% of total births in the United States are premature, with 52% of these infants experiencing neurodevelopment disorders (Brown, 2012). As a result, there is a need to develop measures to reduce morbidity and mortality in order to enhance healthcare outcomes. Noise reduction is critical for supporting normal sleeping patterns in newborns as well as healthy auditory development. Research indicates that exposure to sound in the NICU can disrupt sleep patterns and as well alters the physiological and behavioral responses of both the term and the preterm infants (Cmiel ET AL., 2014). The American Academy of Pediatrics recommends that the NICU be monitored for noise with the noise level not exceeding 50 decibels (Hassanein, Raggal & Shalaby, 2013).

PICOT Question

For preterm neonates in NICU, does the reduction of the Noise stimuli prevent the development of sensory neural disorders compared to those without decrease in noise stimuli?

Evidenced Based research

Research indicates that for neonates that receive developmental care have less behavioral stress and are reported to have longer duration of sleep (Hassanein et al., 2013) .Therefore, through proper developmental care, there is a reduction in physiological stress such as the increased heart rate and subsequent painful experiences. The NICU is a significant source of environmental stress among the premature infants. The standard indicators of the physiological stress and pain include a change in heart rate, the blood pressure, oxygen saturation, palmer sweat and skin blood flow (Johnson, 2014). Determinations of the sound levels that create physiological effects are helpful in determining the specific noise standard for the NICU. Research indicates that the excessive auditory stimulation leads to adverse physiological effects such as the fluctuation of the heart rate, blood pressure, and the oxygen concentration (Knutson, 2012). As a result of the continuous exposure of infants to excessive noise, they are at risk of hearing loss, abnormal brain and sensory development as well as speech and language problems. Further research findings show that a reduction in the noise levels in the NICU helps in the improvement of the physiological stability of the sick neonates and as a result increases the chances of enlarged infant brain development (Knutson, 2012). In a research study to determine the effects of noise among neonates admitted in NICU indicated that, out of the total number of neonate subjects exposed to noise levels of 65dB, 10% of them developed sensory neural hearing loss out of which, 80% had bilateral hearing loss as well as loss in speech frequencies (Wachman & Lahav, 2011). Among the neonates where there was a reduction in the level of sound stimuli, there was no case of sensory neural development loss that was reported.

Nursing Interventions

Nurses working in the NICU have a responsibility in the adjustment the environment through the monitoring of the sound levels, evaluating the sound background of the individual neonate as well as moving away from the neonates that are more sensitive to noise. According to the American Academy of Pediatrics, NICU should have noises or sounds which are within the safe limits for the purpose of ensuring the safe and healthy development of the preterm infants (Karlsso et al., 2014).

Health Care Agency

The Environmental Protection Agency recommends a need for hourly monitoring of the sound levels, and in the event, the noise levels are high, the need for the putting strategies to reduce these levels. In addition, the World Health Organist ion recommends the need for ensuring that the noise and the noise levels do not go beyond 50 dBA (Knutson, 2012).

Nursing practice

The research studies have implication in the field of nursing since there is the need for the nurses to ensure the level of noise and sound stimuli should be decreased. As such, there is the need for increasing the awareness and the role of healthcare workers to minimize the levels of harmful noise. In addition, there is the need for following to the latter the interventions which will ensure a reduction in the cases of complications associated with increased noise and sound levels in the NICU.

Conclusion

The sound levels in the majority of the NICU have been found to be much higher than the recommended standard of 45d BA. In the majority of the preterm’s admitted in the NICU and the sound stimuli are higher than the supported, the neonates end up having developmental problems which limit them in life such as sensory neural hearing loss as well as mental handicap (Slevin et al., 2013). Therefore, there is the need for the healthcare workers and more so the nurse to follow the recommended standards so as to ensure that the neonates achieve positive health outcomes. The nurse, as well as the behaviors, recommended modifications with the aim of lowering the sound level exposure of the neonates.

References

Brown, G. (2012). NICU noise and the preterm infant. Neonatal Network, 28(3), 165-173.

Cmiel, C. A., Karr, D. M., Gasser, D. M., Oliphant, L. M., & Neveau, A. J. (2014). Noise Control: A Nursing Team’s Approach to Sleep Promotion: Respecting the silence creates a healthier environment for your patients. AJN The American Journal of Nursing, 104(2), 40-48.

Hassanein, S. M., El Raggal, N. M., & Shalaby, A. A. (2013). Neonatal nursery noise: practice-based learning and improvement. The Journal of Maternal-Fetal & Neonatal Medicine, 26(4), 392-395.

Johnson, A. N. (2014). Neonatal response to control of noise inside the incubator. Pediatric Nursing, 27(6), 600.

Karlsson, B. M., Lindkvist, M., Lindkvist, M., Karlsson, M., Lundström, R., Håkansson, S., ... & van den Berg, J. (2012). Sound and vibration: effects on infants’ heart rate and heart rate variability during neonatal transport. Acta Paediatrica, 101(2), 148-154.

Knutson, A. J. (2012). Acceptable noise levels for neonates in the neonatal intensive care unit.

Slevin, M., Farrington, N., Duffy, G., Daly, L., & Murphy, J. F. A. (2014). Altering the NICU and measuring infants’ responses. Acta Paediatrica, 89(5), 577-581.

Wachman, E. M., & Lahav, A. (2011). The effects of noise on preterm infants in the NICU. Archives of Disease in Childhood-Fetal and Neonatal Edition, 96(4), F305-F309.