Measuring quiet time in neonatal intensive care units

The soundscape of critical care wards such as Neonatal Intensive Care Units (NICUs) are of particular concern due to the extremely sensitive nature of the patient population. NICUs must be conducive to providing care that enables infants to adapt to the extrauterine world without undue environmental stressors. Although the American Academy of Pediatrics (AAP) and others have set recommended noise limits in the NICU, studies consistently show units exceeding these standards. More nuanced aspects of NICU noise, such as source type, spectral content, fluctuations, and speech intelligibility are also of concern. A long-term study is being conducted that aims to improve NICU soundscapes, including measuring the impact of a Quiet Time (QT) evidence-based practice change. The study is a unique collaboration between engineering, architecture, nursing, and medicine. Detailed acoustic measurements were taken over a 18-month period to assess the soundscape in pre-QT, short-, mid-, and long-term post QT implementation periods. The study methodologies and results will be discussed, including considerations for the complexities of measuring sound fields in NICUs. Results are being used to identify and evaluate soundscape interventions and therefore advance understanding of how to design, measure, and implement healthy NICU soundscapes.