A quiet NICU for improved infants’ health, development and well-being: a systems approach to reducing noise and auditory alarms

A Freudenthal,M Van Stuijvenberg,J B Van Goudoever

doi:10.1007/s10111-012-0235-6

A Freudenthal, M Van Stuijvenberg + Show 1 more

Open Access

https://doi.org/10.1007/s10111-012-0235-6

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Abstract

Noise is a direct cause of health problems, long-lasting auditory problems and development problems. Preterm infants are, especially, at risk for auditory and neurocognitive development. Sound levels are very high at the neonatal intensive care unit (NICU) and may contribute to the frequently observed detrimental outcomes of prematurely born infants. Despite efforts to reduce noise level at the NICU, these have not changed over the past years. Although many authors indicate that a systems approach could solve such interrelated problems, methods to do so are generally lacking for the complicated situation in a critical care setting. A new approach was developed, that is, combining Fuzzy Front End earliest stage product development and human factors methods, with a focus on all Human-tech levels and on their interaction. A concept built up from several emerging technologies was developed, including tactile alarms, artificial intelligence for medicine, multimodal alarm system and mobile communication in critical care. Current and envisioned nursing work was modelled. Outcome of the study is an overview of investigations to develop the measures.

Highlights

The aim of the neonatal intensive care unit (NICU) is to provide an environment, which replaces the womb as much as possible for optimal health recovery and growth
Sound levels are very high at the neonatal intensive care unit (NICU) and may contribute to the frequently observed detrimental outcomes of prematurely born infants
VP refers to Vera Pijl, main designer in stage 1, SL refers to Sanne Langeveld, main designer in stage 2

Summary

Introduction

The aim of the neonatal intensive care unit (NICU) is to provide an environment, which replaces the womb as much as possible for optimal health recovery and growth. The properties of sounds in the NICU, including equipment alarms, and the effect of sounds on the infants as can be found in the literature, will be discussed as well as ongoing incentives to improve these sounds. Williams et al (2007), for example, recorded sound levels exceeding 45 dB more than 70 % of the time during their measurements in three levels of NICU care. These sound levels conflict with guidelines stating that sound levels exceeding 45 dB are cause for concern and should be avoided and that at most 10 % of the time, levels exceeding 50 dB are acceptable, AAP (1997). As compared to ICUs at NICUs, alarms are even more frequently heard, exceeding even the recommended impulse maximum of

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