Noise exposure on preterm infants in the Neonatal Unit : neonatal staff awareness

Abstract

Infants born prior to term gestation are often admitted to the Neonatal Intensive Care Unit [NICU] in view of their increased risk of morbidity and mortality. The presence of technological resources and on-going staff activity, often characterise such unit with loud ambient noise. Evidence-based research has verified several implications of noise exposure on the well- being of preterm infants. Thus, the implementation of noise-reducing measures has proven to be a vital aspect in reducing stress on hospitalised neonates. The aim of this study was to explore local neonatal staff awareness of noise exposure on preterm infants in the neonatal unit. The objectives of this research project were to: assess the recognition of midwives and nurses on Sound Pressure Levels [SPLs] in the neonatal unit, investigate the perceived factors contributing to noise levels in the Neonatal Paediatric Intensive Care Unit [NPICU], identify the knowledge of midwives and nurses of the effects of noise exposure on preterm infants and explore the attitudes and practices of midwives and nurses in relation to noise-reducing measures. A quantitative approach utilising a self-administered questionnaire, was adopted. A sample of fifty midwives and nurses working in the NPICU at the state hospital were selected through convenience sampling, generating a response rate of 86% (n = 43). Collected data was analysed manually and presented in the form of calculated percentages, diagrammatic representations and tables. Findings revealed that although local neonatal staff were not familiar with the recommended sound limit in the neonatal unit, perceived noise levels were comparable to those mentioned in similar studies overseas. While various elements in the NPICU were believed to elevate SPLs at different degrees, the perceived highest and lowest noise-contributing factors were further identified. Although midwives and nurses were knowledgeable of several effects of noise exposure on preterm infants, staff awareness was lacking when certain aspects of physiological response and long-term neurodevelopment were addressed. Moreover, participants’ attitudes towards the efficacy and implementation of noise-reducing measures did not correlate with local practices in the NPICU. For this reason, various recommendations for clinical practice, education and further research were proposed in accordance to the conclusions of this study. The importance of increasing neonatal staff awareness through training and education was highlighted together with the need for establishment of a written noise control protocol.