Wang Ying, Zhang Wei, Li Xing-qi, Yu Li-ming, Wang Ying, Wang Dan-hua
Department of Neonatal Intensive Care Unit (NICU), Beijing Obstetrics and Gynecology Hospital, Capital University of Medical Sciences, Beijing 100026 China.
Zhonghua Er Ke Za Zhi. 2008 Feb;46(2):120-3.
To study the source of noise in level III NICU in Beijing region, evaluate preliminary intervention measures, and improve the NICU environment by reducing the noise.
Noise measurements were performed in level III NICU of three hospitals (A, B and C) in Beijing region by dosimeter (B&K 2231, Denmark), during loud hours and quiet hours. In addition, the loud hours were divided into shift time, nursing time and operating time. "Quiet hours" represents the intervals among shift, nursing and operating time. The noise inside/outside incubator was recorded, measures to reduce the noise, including putting plastic foam in incubator, covering sheet and blanket outside incubator were taken, and an educational program was implemented for the staff to decrease noise in the NICU environment.
Among the three hospitals, the average noise of was (62.60 +/- 2.33) dB during the loud time, and (55.80 +/- 2.61) dB during the quiet time, with a difference of 7 dB (P < 0.05). There was a significant decrease of 2.7 - 3.3 dB during shift time with the averages of A hospital (62.3 +/- 1.5) dB, B hospital (65.10 +/- 2.44) dB and C hospital (61.80 +/- 1.91) dB (F = 9.57, P < 0.05 and P < 0.01), separately. There was a significant decrease of 3 dB during nursing time with the averages of A hospital (62.0 +/- 2.4) dB, B hospital (64.90 +/- 1.06) dB (P < 0.01), respectively, and 2.5 - 3.0 dB during treatment time with the averages of A hospital (60.7 +/- 2.2) dB, B hospital (63.30 +/- 1.19) dB (P < 0.05), separately. After educating the staff in hospital A, there was a significant decrease of 4.7 dB from (61.70 +/- 2.12) dB to (56.90 +/- 2.49) dB in the loud time (P < 0.01), no significant difference during quiet time from (55.0 +/- 1.7) dB to (53.90 +/- 0.88) dB (P > 0.05). There was a significant decrease of 10 dB (P < 0.01) between the averages of inside of incubator (58.60 +/- 3.43) dB and outside of incubator (67.10 +/- 1.87) dB; After installing foam material inside incubator with the average of (56.20 +/- 1.83) dB, there was a significant decrease of 2.8 dB (P < 0.01); covering sheet (in front and back) with the averages of (57.00 +/- 1.47) dB and (55.3 +/- 1.3) dB, respectively, and single or double blanket outside incubator (in the front and the back) noise value (54.50 +/- 1.33) dB, (54.10 +/- 1.15) dB and (54.70 +/- 0.63) dB and (54.10 +/- 1.14) dB, separately, there was a decrease of 1 - 4 dB (P < 0.05 and P < 0.01).
The noise in level III NICU in Beijing region is much higher than that allowed by regulations in Europe and the USA. Staff behavior and the acoustical characteristics of the facility determine the level of noise; herein to staff behavior is the main cause. The level of noise can be lowered considerably by simply making the staff aware of the problem. At the same time, covering incubator and installing plastic foam material also significantly decreased the noise, the methods are simple, feasible and should be applied constantly.
研究北京地区三级新生儿重症监护病房（NICU）的噪声来源，评估初步干预措施，并通过降低噪声来改善NICU环境。
采用丹麦B&K 2231型剂量仪，在北京地区三家医院（A、B、C）的三级NICU中，分别在噪声高峰时段和安静时段进行噪声测量。此外，将噪声高峰时段分为换班时间、护理时间和操作时间。“安静时段”指换班、护理和操作时间之间的间隔。记录培养箱内外的噪声，采取降低噪声的措施，包括在培养箱内放置泡沫塑料、在培养箱外覆盖床单和毯子，并对工作人员实施一项教育计划，以降低NICU环境中的噪声。
三家医院中，噪声高峰时段的平均噪声为（62.60±2.33）dB，安静时段为（55.80±2.61）dB，差值为7 dB（P<0.05）。换班时间内，A医院平均噪声为（62.3±1.5）dB，B医院为（65.10±2.44）dB，C医院为（61.80±1.91）dB，分别显著降低了2.7 - 3.3 dB（F = 9.57，P<0.05和P<0.01）。护理时间内，A医院平均噪声为（62.0±2.4）dB，B医院为（64.90±1.06）dB，分别显著降低了3 dB（P<0.01）；治疗时间内，A医院平均噪声为（60.7±2.2）dB，B医院为（63.30±1.19）dB，分别显著降低了2.5 - 3.0 dB（P<0.05）。对A医院工作人员进行教育后，噪声高峰时段从（61.70±2.12）dB显著降低至（56.90±2.49）dB，降低了4.7 dB（P<0.01），安静时段从（55.0±1.7）dB至（53.90±0.88）dB无显著差异（P>0.05）。培养箱内平均噪声为（58.60±3.43）dB，培养箱外为（67.10±1.87）dB，两者差值为10 dB（P<0.01）；在培养箱内安装泡沫材料后，平均噪声为（56.20±1.83）dB，显著降低了2.8 dB（P<0.01）；在培养箱前后覆盖床单，平均噪声分别为（57.00±1.47）dB和（55.3±1.3）dB，在培养箱前后分别使用单层或双层毯子，噪声值分别为（54.50±1.33）dB、（54.10±1.15）dB和（54.70±0.63）dB、（54.10±1.14）dB，均降低了1 - 4 dB（P<0.05和P<0.01）。
北京地区三级NICU的噪声远高于欧美规定的标准。工作人员行为和设施的声学特性决定了噪声水平，其中工作人员行为是主要原因。仅通过让工作人员意识到问题，就能大幅降低噪声水平。同时，覆盖培养箱和安装泡沫塑料材料也显著降低了噪声，这些方法简单可行，应持续应用。
