title: Neonatal nursery noise: practice-based learning and improvement.
abstract: OBJECTIVE
  To study the impact of interrupted loud noise in Neonatal Intensive Care Unit (NICU) on neonatal physiologic parameters, and apply methods to alleviate noise sources through teaching NICU's staff.
  
  
  METHODS
  Noise level measured at different day times and during different noisy events in the NICU. Changes in the heart rate, respiratory rate and oxygen saturation were recorded just before and immediately after providing noisy events for 36 preterm and 26 full-term neonates. Focused training, guided by sound-level-meter, was provided to the NICU's staff to minimize noise.
  
  
  RESULTS
  The highest mean baseline noise level, 60.5 decibel (dB), was recorded in the NICU critical care area at 12:00 am. The lowest level, 55.2 dB was recorded at 10:00 pm. Noise level inside the incubators was significantly lower than outside, p < 0.001. Noisy events resulted in a significant increase in heart and respiratory rates in preterm neonates as compared to full-terms, p < 0.05.
  
  
  CONCLUSIONS
  Noise in our NICU exceeded the international permissible levels. Noisy events are numerous, which altered the neonates' physiologic stability especially preterm infants. Staff education is mandatory in ameliorating noise pollution with its deleterious effects on neonatal physiologic homeostasis.
authors.affiliation: Department of Pediatrics, Ain Shams University, Cairo, Egypt. saharhassanein@med.asu.edu.eg
authors.forename: Sahar M A
authors.initials: SM
authors.lastname: Hassanein
authors.forename: Nehal M
authors.initials: NM
authors.lastname: El Raggal
authors.forename: Amani A
authors.initials: AA
authors.lastname: Shalaby
mesh_terms: D056902:Clinical Alarms; D003448:Crying; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D009622:Noise / Q000009:adverse effects* / Q000517:prevention & control*; D010100:Oxygen / Q000097:blood; D056152:Respiratory Rate / Q000502:physiology; D013060:Speech; D013689:Telephone
chemical_list: D010100:Oxygen