Noise solutions in NICU

[smfeitoza]

We are researching here in Spain, ways that preemies are protected from noise in NICU. Can we get feedback on best and worse solutions? We have seen earmuffs, but understand these are not being used as much, with evidence growing against use. Besides quiet programs in hospitals are there techniques or products you would recommend? It would really help to get feedback and ideas as well. Thanks in advance.

[nocturnalnurse]

Quiet environment is really the best thing you can do. Keep less sick babies happy to help prevent loud crying. Put infants needing sound restriction in isolettes with the tops down/sides up to dampen outside sounds. Have your nurses give report to eachother/doctors/via phone/to parents outside of the immediate area whenever possible. Our nurses sit at a desk behind glass, for example. Phones in that room can be set at a quieter volume or even a flash indicator. You can post signs to help your staff remember. You can install sound absorbing materials for the ceilings/walls if need be but really if you are going to that extreme your staff probably needs more education on being quiet! If you use carts that are moved around they should have rubber wheels. Instructing all parents prior to visits that the NICU is a quiet zone and if they talk to their infant it should be in quiet voices and they should limit talking amongst themselves, silence cell phones and pages, etc... Alarms on monitors should obviously always be audible but if you have a nurse sitting in the area of the sick infants (as you should) they don't necissarily have to be on the HIGHEST setting. Our hospital is now implementing "silent codes" whereas there is no yelling, multiple voices, etc... during a code. everyone accept the code leader performs their tasks quietly without talking accept to ask pertinent questions or verify orders given by the code leader. I can't see how placing anything on the infant specifically would be a good idea (ie. earmuffs). others will likely have good ideas as well.

[Bortaz, MSN, RN]

One of the local hospitals has a system with traffic lights set to flash from green to yellow to red when certain decibels of noise are detected. If it starts to get a little noisy in an are, the yellow light comes on, if it continues, it goes to red. These lights and sensors are all over the unit, and are intended to alert staff that noise levels are getting too high. When it gets to red, Management is alerted by the system.

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[Bortaz, MSN, RN]

Sorry, double post.

[smfeitoza]

Thank you for your insights! What about earmuffs on the babies to keep the sound out? Are you using them or not? I have read mixed reviews that they fall off. We are looking at a better way to block the bad sound (high decibel noise) reaching the babies. If human behavior modification is hot or miss sometimes what else works on the baby?

[smfeitoza]

Thank you for your insights! So staff is incentivized to keep it quiet due to repercussions by the noise alert system. Our reality is a bit different here in Spain. Nurses seemed to not like idea of big brother monitoring in that way. Does it really work? Real consequences from management down to staff?

What about earmuffs on the babies to keep the sound out? Are you using them or not? I have read mixed reviews that they fall off. We are looking at a better way to block the bad sound (high decibel noise) reaching the babies. If human behavior modification is hit or miss sometimes what else works on the baby?