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Effect of Environmental Changes on Noise in the NICU

Brandon, Debra H. PhD, RN, CCNS; Ryan, Donna J. RN, MSN; Barnes, Angel H. RN, BSN

doi: 10.1097/01.ANC.0000337266.47599.c9

Purpose To evaluate die effect of changes in die NICU environment on sound levels.

Design Aprospective quasi-experimental design evaluated sound levels in a 43-bed NICU. Decibel levels were monitored utilizing a data-logging dosimeter for 24 hours weekly over 12 montiis. Sound levels were also measured inside four different incubator models.

Sample Forty-four 24-hour decibel recordings were obtained in one of eight randomly selected four-bed pods. In addition, a single 1-hour recording was obtained in four different models of vacant incubators.

Main Outcome Variable Ambient sound levels.

Results Decibel levels were analyzed to identify changes in noise levels following alterations in the NICU environment. Installation of motion-sensing motorized paper towel holders significantly increased levels at beds closest to the towel dispensers, as did the trial of a new communication system. Decibel levels in four different incubators revealed varying noise levels. This study suggests that all environmental changes must be monitored to ensure that they reduce rather than increase noise levels.

Debra H. Brandon completed her undergraduate, masters, and doctoral education at the University of North Carolina at Chapel Hill. Debra has worked in neonatal nursing for over 30 years. She has held a variety of clinical and leadership roles and is currently an associate professor in the Duke University School of Nursing and the neonatal clinical nurse specialist for the intensive care nursery at Duke University Hospital. Her research interests center around the care of high-risk infants and their families, specifically, the effects of the hospital environment on the health and development of preterm infants.

Donna J. Ryan completed her undergraduate studies at the University of North Carolina at Chapel Hill before finishing her graduate studies at Duke University. Donna has cared for critically ill neonates for over 20 years and has most recently been responsible for the administration of the cycled light study as clinical research coordinator. Her clinical and research interests lie with developmental care of neonates.

Angel H. Barnes received her nursing degree from the University of North Carolina at Charlotte. Angel has cared for critically ill neonates in the NICU at Duke University Medical Center for five years. She is currently a clinical research nurse at the Duke University School of Nursing and has been involved in research for four years.

For further information, please contact: Debra H. Brandon, PhD, RN, CCNS Box 3322, Duke University School of Nursing Durham, NC 27710 E-mail:

Reprinted with permission. Brandon DH, Ryan DJ, Barnes AH. Effect of environmental changes on noise in the NICU. Neonatal Network. 2007; 26(4):213–218.

The preparation of this article was supported in part by Grant 5 R01 NR08044-02 from the National Institute for Nursing Research, National Institutes of Health.

The study was judged by the Duke University School of Nursing Internal Review Board, Durham, North Carolina, to be in the exempt category of research.

Accepted for publication March 2006. Revised October 2006.

© 2008 National Association of Neonatal Nurses