PDF herunterladen
Am J Perinatol 2022; 39(02): 189-194
DOI: 10.1055/s-0040-1714679
Original Article

Assessment of Neonatal Intensive Care Unit Sound Exposure Using a Smartphone Application

Christine Capriolo
1   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
,
Rose M. Viscardi
1   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
,
Karen A. Broderick
2   Department of Pediatrics, St. Agnes Hospital, Baltimore, Maryland
,
Sepideh Nassebeh
2   Department of Pediatrics, St. Agnes Hospital, Baltimore, Maryland
,
Michael Kochan 
1   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
,
Nina S. Solanki
3   Department of Pediatrics, Jersey Shore University Medical Center Neptune City, Neptune City, New Jersey
,
Jocelyn C. Leung 
1   Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
› Institutsangaben Funding None.
› Weitere Informationen
    Lizenzen und Reprints

Abstract

Objective This study aimed to determine the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures. We hypothesized that monitoring with a smartphone application would identify modifiable environmental factors in different NICU design formats.

Study Design Minimum, maximum, and peak decibel (dB) recordings were obtained using the Decibel X phone app, and the presence of noise sources was recorded in each patient space at three NICUs over a 6-month period (December 2017 to May 2018). Data were analyzed by Student's t-test and ANOVA with Bonferroni correction. Data were collected at the University of Maryland Medical Center single family room (SFR) level IV and St. Agnes Healthcare hybrid pod/single family room level III NICU, Baltimore, MD and at Prince George's Hospital Center open-pod design Level III NICU, Cheverly, MD.

Results All recordings in the three NICUs exceeded the American Academy of Pediatrics (AAP) recommended <45 dB level. The maximum and peak dB were highest in the open pod format level III NICU. Conversations/music alone and combined with other factors contributed to increased sound exposure. Sound exposure varied by day/night shift, with higher day exposures at the level III hybrid and open pod NICUs and higher night exposures at the level IV SFR NICU.

Conclusion Although sound exposure varied by NICU design, all recordings exceeded the AAP recommendation due, in part, to potentially modifiable environmental factors. A smartphone application may be useful for auditing NICU sound exposure in quality improvements efforts to minimize environmental sound exposure.

Key Points

  • Smartphone application was used to assess NICU sound exposure.

  • All cases of sound exposure exceed recommendations.

  • A smartphone application was used to identify modifiable factors.

Keywords

NICU design - sound exposure - smartphone application - sound monitoring

Authors' Contributions

C.C. and J.C.L. conceptualized and designed the study including acquisition and analysis of the data, drafting, and revising content. R.M.V. contributed to conception and study design, analysis and interpretation of the data, and revision of content. K.A.B., S.N., M.K., and N.S.S. contributed to data acquisition and assisted in critical revision of content. All authors approved the final version of the manuscript.




Publikationsverlauf

Eingereicht: 16. Dezember 2019

Angenommen: 22. Juni 2020

Artikel online veröffentlicht:
23. Juli 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 American Academy of Pediatrics. Noise: a hazard for the fetus and newborn. American Academy of Pediatrics. Committee on Environmental Health. Pediatrics 1997; 100 (04) 724-727
    CrossrefPubMedGoogle Scholar
  • 2 Garinis AC, Liao S, Cross CP. et al. Effect of gentamicin and levels of ambient sound on hearing screening outcomes in the neonatal intensive care unit: a pilot study. Int J Pediatr Otorhinolaryngol 2017; 97: 42-50
    CrossrefPubMedGoogle Scholar
  • 3 Marlow ES, Hunt LP, Marlow N. Sensorineural hearing loss and prematurity. Arch Dis Child Fetal Neonatal Ed 2000; 82 (02) F141-F144
    CrossrefPubMedGoogle Scholar
  • 4 Leung JC, Cifra CL, Agthe AG, Sun CC, Viscardi RM. Antenatal factors modulate hearing screen failure risk in preterm infants. Arch Dis Child Fetal Neonatal Ed 2016; 101 (01) F56-F61
    CrossrefPubMedGoogle Scholar
  • 5 Yoon PJ, Price M, Gallagher K, Fleisher BE, Messner AH. The need for long-term audiologic follow-up of neonatal intensive care unit (NICU) graduates. Int J Pediatr Otorhinolaryngol 2003; 67 (04) 353-357
    CrossrefPubMedGoogle Scholar
  • 6 White RD, Smith JA, Shepley MM. Committee to Establish Recommended Standards for Newborn ICU Design. Recommended standards for newborn ICU design, eighth edition. J Perinatol 2013; 33 (Suppl. 01) S2-S16
    CrossrefPubMedGoogle Scholar
  • 7 Chawla S, Barach P, Dwaihy M. et al. A targeted noise reduction observational study for reducing noise in a neonatal intensive unit. J Perinatol 2017; 37 (09) 1060-1064
    CrossrefPubMedGoogle Scholar
  • 8 Ahamed MF, Campbell D, Horan S, Rosen O. Noise reduction in the neonatal intensive care unit: a quality improvement initiative. Am J Med Qual 2018; 33 (02) 177-184
    CrossrefPubMedGoogle Scholar
  • 9 Parra J, de Suremain A, Berne Audeoud F, Ego A, Debillon T. Sound levels in a neonatal intensive care unit significantly exceeded recommendations, especially inside incubators. Acta Paediatr 2017; 106 (12) 1909-1914
    CrossrefPubMedGoogle Scholar
  • 10 Van Enk RA, Steinberg F. Comparison of private room with multiple-bed ward neonatal intensive care unit. HERD 2011; 5 (01) 52-63
    CrossrefPubMedGoogle Scholar
  • 11 Ramm K, Mannix T, Parry Y, Gaffney MPC. A comparison of sound levels in open plan versus pods in a neonatal intensive care unit. HERD 2017; 10 (03) 30-39
    CrossrefPubMedGoogle Scholar
  • 12 Lester BM, Hawes K, Abar B. et al. Single-family room care and neurobehavioral and medical outcomes in preterm infants. Pediatrics 2014; 134 (04) 754-760
    CrossrefPubMedGoogle Scholar
  • 13 Mörelius E, Broström EB, Westrup B, Sarman I, Örtenstrand A. The Stockholm Neonatal Family-Centered Care Study: effects on salivary cortisol in infants and their mothers. Early Hum Dev 2012; 88 (07) 575-581
    CrossrefPubMedGoogle Scholar
  • 14 Als H, Lawhon G, Brown E. et al. Individualized behavioral and environmental care for the very low birth weight preterm infant at high risk for bronchopulmonary dysplasia: neonatal intensive care unit and developmental outcome. Pediatrics 1986; 78 (06) 1123-1132
    CrossrefPubMedGoogle Scholar
  • 15 Barreto ED, Morris BH, Philbin MK, Gray LC, Lasky RE. Do former preterm infants remember and respond to neonatal intensive care unit noise?. Early Hum Dev 2006; 82 (11) 703-707
    CrossrefPubMedGoogle Scholar
  • 16 Benini F, Magnavita V, Lago P, Arslan E, Pisan P. Evaluation of noise in the neonatal intensive care unit. Am J Perinatol 1996; 13 (01) 37-41
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 17 Duran R, Çiftdemir NA, Özbek ÜV. et al. The effects of noise reduction by earmuffs on the physiologic and behavioral responses in very low birth weight preterm infants. Int J Pediatr Otorhinolaryngol 2012; 76 (10) 1490-1493
    CrossrefPubMedGoogle Scholar
  • 18 Pineda RG, Neil J, Dierker D. et al. Alterations in brain structure and neurodevelopmental outcome in preterm infants hospitalized in different neonatal intensive care unit environments. J Pediatr 2014; 164 (01) 52-60.e2
    CrossrefPubMedGoogle Scholar
  • 19 Ibekwe TS, Folorunsho DO, Dahilo EA, Gbujie IO, Nwegbu MM, Nwaorgu OG. Evaluation of mobile smartphones app as a screening tool for environmental noise monitoring. J Occup Environ Hyg 2016; 13 (02) D31-D36
    CrossrefPubMedGoogle Scholar
  • 20 Zamora W, Calafate CT, Cano JC, Manzoni P. Accurate ambient noise assessment using smartphones. Sensors (Basel) 2017; 17 (04) 1-18
    CrossrefPubMedGoogle Scholar
  • 21 Kardous CA, Shaw PB. Evaluation of smartphone sound measurement applications (apps) using external microphones: a follow-up study. J Acoust Soc Am 2016; 140 (04) EL327-EL327
    CrossrefPubMedGoogle Scholar
  • 22 Nast DR, Speer WS, Le Prell CG, Le P. Sound level measurements using smartphone “apps”: useful or inaccurate?. Noise Health 2014; 16 (72) 251-256
    CrossrefPubMedGoogle Scholar
  • 23 Gilmour D, Duong KM, Gilmour IJ, Davies MW. NeoSTRESS: study of transfer and retrieval environmental stressors upon neonates via a smartphone application - Light. Air Med J 2020; 39 (02) 97-102
    CrossrefPubMedGoogle Scholar
  • 24 Goyal A, Gopalakrishnan M, Anantharaman G, Chandrashekharan DP, Thachil T, Sharma A. Smartphone guided wide-field imaging for retinopathy of prematurity in neonatal intensive care unit - a Smart ROP (SROP) initiative. Indian J Ophthalmol 2019; 67 (06) 840-845
    CrossrefPubMedGoogle Scholar
  • 25 Meredith JL, Jnah A, Newberry D. The NICU environment: infusing single-family room benefits into the open-bay setting. Neonatal Net 2017; 36 (02) 69-76
    CrossrefPubMedGoogle Scholar
  • 26 Smith SW, Ortmann AJ, Clark WW. Noise in the neonatal intensive care unit: a new approach to examining acoustic events. Noise Health 2018; 20 (95) 121-130
    PubMedGoogle Scholar
  • 27 Swathi S, Ramesh A, Nagapoornima M. et al. Sustaining a “culture of silence” in the neonatal intensive care unit during nonemergency situations: a grounded theory on ensuring adherence to behavioral modification to reduce noise levels. Int J Qual Stud Health Well-being 2014; 9: 22523 DOI: 10.3402/qhw.v9.22523.
    CrossrefPubMedGoogle Scholar
  • 28 Garfield CF, Lee YS, Kim HN. et al. Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application. Internet Interv 2016; 4 (Pt 2): 131-137
    CrossrefPubMedGoogle Scholar
  • 29 Pineda R, Durant P, Mathur A, Inder T, Wallendorf M, Schlaggar BL. Auditory exposure in the neonatal intensive care unit: room type and other predictors. J Pediatr 2017; 183 (183) 56-66.e3
    CrossrefPubMedGoogle Scholar
  • 30 Szymczak SE, Shellhaas RA. Impact of NICU design on environmental noise. J Neonatal Nurs 2014; 20 (02) 77-81
    CrossrefPubMedGoogle Scholar
  • 31 Johnson AN. Neonatal response to control of noise inside the incubator. Pediatr Nurs 2001; 27 (06) 600-605
    PubMedGoogle Scholar