[Can we improve the neuro-intellectual and behavioral prognosis of premature infants by modifying their environment?]

[Noise in neonatology, the impact of hospital staff]

OBJECTIVES

To identify the various sources of noise in a neonatal intensive care unit in a university hospital centre and to assess the noise level.

METHODS

The nursing staff was interviewed to obtain a qualitative assessment of the noise in the department. Quantitative observations using a sound level meter and a dosimeter were then made. The measurements presented here were carried out in two different units caring for the newborn: on the heated table and in an incubator.

RESULTS

Many sources of noise were identified in the unit. They were responsible for a noisy environment, the level of which was far greater than current recommendations and left few periods of quiet. The alarms of the various monitors and maintenance apparatuses, the crying of the newborn and the activity of the staff were the principal sources of noise.

CONCLUSION

The impact of hospital staff on the extent and frequency of sources of noise is crucial. An enhanced awareness strategy should therefore be developed.

[Implementation of an individualized program of sustained development in neonatal intensive care: why, how?]

The Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) is based upon a behavioral observation of the premature newborn. The information is used for suggesting individualized caregiving and environmental changes. The role of the parents in supporting the development is reinforced. This program appears to reduce ventilation, artificial feeding and hospitalization stay length, and is also found to improve neurobehavioral maturation. Its setting in a neonatal intensive care unit implies a collective reflective process and staff education.