Implementation of a quiet hour: effect on noise levels and infant sleep states.

It is necessary to decrease environmental stimuli in order to provide developmentally supportive care to the very low birthweight (VLBW) infant, thereby enhancing the sleep/wake cycle and possibly physiologic stability. The purpose of this study was to determine if it was possible to decrease the noise level in the Developmental Unit, and promote sleep states in infants on the unit. After determining control noise levels and infant state, the last hour of each shift was designated a Quiet Hour. During this time, noise levels were monitored in the room in five locations. Infant sleep states were also noted. The results indicate that noise levels decreased significantly on two of the three shifts. Fewer infants were crying during the Quiet Hour than the control period (2.4 vs 14.3 percent), and more were in deep or light sleep (84.5 vs 33.9 percent). This study demonstrates that noise levels in Developmental Units can be significantly decreased, and that the decreased noise levels positively impact infant state. By enhancing sleep states, nurses can enhance the long term developmental outcome of the VLBW infant. However, the reduction of noise is highly dependent on the collaborative efforts of all health care providers within the unit.