title: Sound level exposure of high-risk infants in different environmental conditions.
abstract: OBJECTIVE
  To provide descriptive information about the sound levels to which high-risk infants are exposed in various actual environmental conditions in the NICU, including the impact of physical renovation on sound levels, and to assess the contributions of various types of equipment, alarms, and activities to sound levels in simulated conditions in the NICU.
  
  
  METHODS
  Descriptive and comparative design.
  
  
  METHODS
  Convenience sample of 134 infants at a southeastern quarternary children's hospital.
  
  
  METHODS
  A-weighted decibel (dBA) sound levels under various actual and simulated environmental conditions.
  
  
  RESULTS
  The renovated NICU was, on average, 4-6 dBA quieter across all environmental conditions than a comparable nonrenovated room, representing a significant sound level reduction. Sound levels remained above consensus recommendations despite physical redesign and staff training. Respiratory therapy equipment, alarms, staff talking, and infant fussiness contributed to higher sound levels.
  
  
  CONCLUSIONS
  Evidence-based sound-reducing strategies are proposed. Findings were used to plan environment management as part of a developmental, family-centered care, performance improvement program and in new NICU planning.
authors.affiliation: School of Nursing, University of Central Florida, Orlando 32816-2210, USA. jbyers@mail.ucf.edu
authors.forename: Jacqueline F
authors.initials: JF
authors.lastname: Byers
authors.forename: W Randolph
authors.initials: WR
authors.lastname: Waugh
authors.forename: Linda B
authors.initials: LB
authors.lastname: Lowman
mesh_terms: D002657:Child Development; D015400:Clinical Nursing Research; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis* / Q000517:prevention & control; D004784:Environmental Monitoring / Q000379:methods; D004868:Equipment Failure; D006272:Health Facility Environment / Q000458:organization & administration*; D006749:Hospital Design and Construction / Q000592:standards*; D006776:Hospitals, Pediatric; D006801:Humans; D007186:Incubators, Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D015931:Intensive Care, Neonatal / Q000458:organization & administration; D007374:Interior Design and Furnishings / Q000592:standards; D017283:Neonatal Nursing / Q000458:organization & administration; D009622:Noise / Q000009:adverse effects / Q000517:prevention & control; D012121:Respiration, Artificial; D013018:Sound Spectrography; D015144:Southeastern United States; D017749:Total Quality Management / Q000458:organization & administration