Preterm Infants in NICU and ambient noise

Preterm infants in the NICU are subjected to ambient noise levels that frequently exceed the acceptable levels. Because of the extremely sophisticated procedures and extensive equipment employed in ICU settings, loud and high-pressure noise levels are to be expected. The rapid advancement of technology in hospitals is transforming them into chaotic places with constant illumination and high sound pressure levels. The respiratory equipment and incubator fans are most likely contributing to the overall noise levels. Extended exposure to these settings can be hazardous in many ways, including physiologically, behaviorally, psychologically, and in terms of sleep pattern (Goldson, 2009). Therefore, the project seeks analyses the impacts noise, suggestions and educational initiatives that should be embraced in order to minimize noise in NICU (Newton, 2009).

The Effect of noise on neonates includes increased hormone and adrenaline release, vasoconstrietion, elevated blood pressure and increased oxygen consumption rates (Sizun, 2016). Noise causes apnoea and hypoxaemia, conditions that alter the oxygen saturation levels which is important for heart and respiratory systems. Excess or low oxygen levels may exceed or lower the amount of calories available which results in stunted or premature growth. More so, hearing loss, pupil dilation and delayed weight gain are some of the bearings of excessive sound and illumination. Also, injured cochlea and predispose to ventricular hemorrhage are common effects of noise and this is not an exception to premature infants (Fanaroff, Fanaroff & Klaus, 2013). Lactogenic effects include bilateral hearing loss, difficulty in processing auditory inputs and sensory problems.

Loud transient noise causes a reflex on the eyes of the infant which may alter the course of development for the pupils. Illumination also causes dilatation and constriction of the retina. In addition, sleep disorders are evident in most infants subjected to these conditions because of the constant changes in thermoregulation and production of hormones. Such symptoms may eventually weaken the infant’s immunity. To add on, sleep disorder may cause excessive crying, irritability and constant rise in intracranial pressure (Eggermont, 2014). Among other deleterious impacts include changes in muscle tone, headaches and irritability.

Suggestions/Recomendations

As a result of the aforementioned effects, intervention initiatives are necessary for better service delivery in NICU. Firstly, the primary solution would be architectonic changes, adoption of luminosity control, and use of friendly/less noisy equipment (In Gardner et al., 2017). Among other initiatives include minimal contact with infants and adopting educational programs to their families and multi-professional team (Anand, 2017). The ambience of NICU should also minimize its noise levels within the recommended levels. Current guidelines suggest that sound levels in infant units should not exceed 45 dB (Goldson, 2009). More so, noise exposure in NICU should be evaluated routinely and then reduced to appropriate levels. It should be a basic provision that all incubators must be fitted with acoustical foam in order to reduce the amount of noise in the incubator. More importantly NICU walls, drawers, doors, trash cans and units should all be padded and ceilings must be constructed using acoustic tiles (Polin, 2014).

Finally, educational approach is an important remedy to curb increased noise levels. For instance, it should be mandatory for all staff involved in the neonatal care to take a development care course that addresses the importance of maintaining an ample environment in the ICU (Newton, 2009). Nurses should be taught how to minimize bedside conversations and doctors/caregivers should make regular hospital rounds in order to ensure that the place is as quiet as possible. Moe so, discussing patient’s care plan away from the neonate is an important part of the prevention solution (Kenner & Lott, 2007). Findings from the analysis show that noise perceived by infants result in decreasing of affective, emotional and sensorial changes. To solve the problem, this project recommends staff training, improvement of ICU conditions and minimal contact with infants.

References

Anand, K. J. S. (2017). Pain in neonates and infants. Edinburgh: Elsevier.

Eggermont, J. J. (2014). Noise and the brain: Experience dependent developmental and adult plasticity.

Fanaroff, A. A., Fanaroff, J. M., & Klaus, M. H. (2013). Klaus & Fanaroff's care of the high-risk neonate. Philadelphia, PA: Elsevier/Saunders.

Goldson, E. (2009). Nurturing the premature infant: Developmental interventions in the neonatal intesive care nursery. New York [u.a.: Oxford Univ. Press.

In Gardner, S. L., In Carter, B. S., In Hines, M. E., In Hernandez, J. A., STAT!Ref (Online service), & Teton Data Systems (Firm). (2016). Merenstein & Gardner's handbook of neonatal intensive care. St. Louis, Missouri: Elsevier.

Kenner, C., & Lott, J. W. (2007). Comprehensive neonatal nursing: An interdisciplinary approach. St. Louis, MO: Saunders Elsevier.

Nery, E. (2015). Effects of “quiet time” to reduce noise at the neonatal intensive care unit. Scielo. Sao Paulo Hospital of teh Federal University. Print.

Newton, V. E. (2009). Paediatric audiological medicine. Malden, MA: Wiley-Blackwell.

Polin, R. A. (2014). Fetal and neonatal secrets [recurso electrónico]. Estados Unidos: Elsevier Inc.

Sizun, J. (2016). Research on early developmental care for preterm neonates. London: John Libbey.