Ahamed Mohamed Farooq, Campbell Deborah, Horan Susan, Rosen Orna
1 Southern Illinois University School of Medicine, Springfield, IL.
2 The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY.
Am J Med Qual. 2018 Mar/Apr;33(2):177-184. doi: 10.1177/1062860617711563. Epub 2017 Jun 6.
Exogenous noise has deleterious effects on the developing fetus and infant. The aim of this quality improvement project was to lower the mean ambient noise level within a level IV neonatal intensive care unit (NICU) by 10% from the baseline in one year. Multiple noise reduction strategies were tested through Plan-Do-Study-Act cycles based on the Institute for Healthcare Improvement model for improvement. Strategies targeted environmental and behavioral modifications. Noise levels were recorded continuously; means and peaks were calculated. The mean noise level decreased from 62.4 dB to 56.1 dB, and peak noise level decreased from 115 dB to 76 dB within 12 months. Day shift noise level decreased by 7.7 dB; night shift noise level decreased by 4.9 dB from baseline. Targeted education, behavioral, and environmental modifications decreased the noise level in the NICU as per the study aim. To create a change in culture, constant dialogue between the project champions and the NICU staff is necessary.
外源性噪音对发育中的胎儿和婴儿有有害影响。这个质量改进项目的目标是在一年内将四级新生儿重症监护病房（NICU）内的平均环境噪音水平从基线降低10%。基于医疗改进研究所的改进模型，通过计划-执行-研究-行动循环测试了多种降噪策略。策略针对环境和行为的改变。噪音水平持续记录；计算平均值和峰值。在12个月内，平均噪音水平从62.4分贝降至56.1分贝，峰值噪音水平从115分贝降至76分贝。日班噪音水平从基线下降了7.7分贝；夜班噪音水平下降了4.9分贝。根据研究目标，有针对性的教育、行为和环境改变降低了NICU的噪音水平。为了实现文化变革，项目负责人与NICU工作人员之间持续对话是必要的。
