Developments in the Neonatal care have been able to offer some supplements to aid in addressing the problem of noise found at Neonatal Intensive Care Nursery. The supplements for this purpose is composed of several works which have been published regarding the noise problem and the nurses responsibilities that improvements are achieved in order to offer the patients with credible services (WITT, 2008).
Neonatal Intensive Care Unit
Noise has a lot of effects which are detrimental in nature to the preterm neonate. Physiological responses which include fluctuations of blood pressure, heart beat rate, oxygen saturation and the rate of respiration as a result of noise have been well demonstrated by various research works. Some research studies have shown that there are effects which are long term due to being exposed to noise while in the Neonatal Intensive Care Unit (NICU). Although it is not easy to establish causes of decline in hearing acuteness among preterm infants, there is need to be concerned about the levels of noise and especially if such levels exceed the norms, thus being detrimental to the ability of hearing in adults as well as older children. Apart from the potential risk of loosing the ability of hearing in the long run, the concern of being exposed fore long periods to environmental noise is also of essence as it can significantly contribute major other problems in the long term such as having difficulties in being attentive (WITT, 2008).
For the case of utero, the amniotic fluid filters the sounds and thus the fetus is well protected from the effects of noise whether it is of high, mid or low frequencies and thus focuses on maternal voice only. This changes completely in the NICU as the environment is quite different and the preterm infant finds itself exposed to several varieties of sounds which are received at frequencies which are virtually unpredictable. The ability of the preterm neonate is limited in terms of being able to distinguish different sounds, such as mechanical noises and voices. Therefore, it usually has a lot of difficulties in tuning out or habituating such sounds which amount to noise (Johnson, 2003).
The staff can also be affected by environmental sounds, in fact, the institute of deafness which also deals with other communication illnesses estimates that about ten percent of the adults aged between thirty and seventy years, have suffered hearing damage which is permanent, mainly as a result of being exposed to secondary environmental noises in excess. Apart from suffering from the problem of hearing, adults have most of the matching physiological alterations as with the premature infants. When one is exposed to noise on several occasions, the levels of fatigue increases and thus more energy is required to perform the extra activities which make communication with others quite difficult. Intensive Care Units (ICU), for the newborns should meet certain minimum requirements. The rooms for these infants and also the rooms where the adults sleep, should not be exposed to sound levels of L10 of 50 dB and Leq 45 dB on hourly basis. This is based on the combination of both operational sounds and background noises which are continuous. The sounds which are transient in nature also known as Lmax should not go beyond 65 dB in the above mentioned rooms (Johnson, 2003).
Despite the ranging controversy concerning the issue of noise in the NICU, much literature supports the use of music as a strategy of developing care for the preterm infants. Such literature indicate that music enhances both the neurobehavioral and physiologic functioning although there are some experts who are worried about the effect of noise arguing that it is over stimulating. Nurses provide music therapy for babies and their mothers; this is usually done during the pregnancy period more so during late pregnancies. The pregnant mothers have a chance to take an active role in developing the music together with the music therapist. They also get the chance of learning a wide variety activities involved in music which is relevant and suitable to their infants (WITT, 2008).
There is a parallel facility offering musical interventions inside the NICU for mothers and their babies that is intended at meeting the needs and the standards of the NICU as required by the nurses. Currently there is in existence, some literature that is related to music therapy. The music therapy should go on until the baby and the mom are discharged but it should continue even at home. The existence of lullabies and music soothes provides evidence to show that mothers believe that music is capable of quieting babies. For several years more and more evidence has been gathered which show that music is capable of improving premature infant’s growth and also physiological responses. Such young babies are exposed to noise which is disturbing. However, music has very special properties which are capable of neutralizing the detrimental effects caused by such noises (Johnson, 2003).
The view which is held by the nurses that music is suitable for premature infants is well supported by Meta analysis. The analysis showed that music that is between 55 and 80 dB is highly associated with significant improvements in the state of an infants behavior, the rate of heart beat, saturation of oxygen, the rate of feeding, respiration rate, weight gain, the rate of non nutritive sucking and the period of staying in hospital. Use of music, and especially intrauterine sounds effects can be implemented along side the techniques of music therapy and can have immense impact on the development of the premature infants. Some studies show that the new born infants especially the ones which are prematurely born might have remarkable responses unmistakably to intrauterine sounds and to voices. This is more so when such voices are entrained to the heart beat of the baby and its respiratory rate. Thus the use of music therapy and other interventions are very important signs and parameters of development of developing premature infants. Music therapy is therefore very important in the development of the infants’ right from the time they are in their mother’s womb and also once they are born as music is very vital in eliminating noises which have detrimental effects to the children and also to the adults (Johnson, 2003).
The nurses have therefore; have a duty of advocating for healthier environments which are free of noises. The nurses have the responsibility of ensuring that the noise standards which are set in the NICU are observed at all times. Nurses should research works being carried out into the noise effects on the brain which is developing. They must also be willing to educate families, patients, and the general public concerning the detrimental effects caused by environmental noises. They should avoid addressing the NICU noise in isolation but should in fact be concerned on virtually all the environmental noises as a whole since noise can be controlled both in the general environment and in the NICU.
WITT, C. L. (2008): Addressing Noise in the NICU, Journal article of Advances in Neonatal Care, Vol. 8, Issue 5.
Johnson, A.N. (2003): Adapting the Neonatal Intensive Care Environment to Decrease Noise, Journal article of neonatal nurses, Vol. 17, Issue 4.