Story source: Stanley Graven, MD, (813) 974-6694
Media contact: Anne DeLotto Baier, (813) 974-3300
NEONATAL INTENSIVE CARE UNITS NEED A KINDER, GENTLER APPROACH TO CARE OF NEWBORNS, USF RESEARCHER SAYS
Tampa, FL (1997, Dec. 6) -- The glaring lights, harsh noises and disruptive, painful procedures in many neonatal intensive care units may deter the development of tiny newborns and should be subdued, said a University of South Florida researcher who heads a national study examining the effects of the NICU environment on high-risk infants.
Of the nation's 850 NICUs, only a small number have formal programs to control bright lights and loud noises that interfere with premature infants' neurological development, said Stanley Graven, MD, a pediatrician and professor in the USF College of Public Health. However, he said, a growing number of NICUs have begun to set aside times when infants cannot be disturbed by injections, intubations and suctioning, except if emergency care is required.
Dr. Graven reported on the Developmental Environment of the High Risk Infant Study and its implications for the care of NICU infants Dec. 6 at the National Perinatal Association Clinical Conference. He is accumulating an impressive body of evidence to demonstrate that continuous lights, intense noises and odors, and painful or uncomfortable procedures can inhibit the physiological stability, recovery and growth of premature infants.
"Over the last 20 years, NICUs have been designed almost exclusively around the newest technology to keep babies alive," he said. "But a kinder, gentler NICU is not incompatible with a technologically advanced unit."
It is important to improve the quality of life for infants in the NICU, in addition to emphasizing advanced medical treatment, because more low-birth-weight babies are surviving and spending more time in these units, he said. Each year nearly 200,000 infants in the United States spend two to six months in NICUs.
Dr. Graven, founding president of the National Perinatal Association, is working with representatives from several maternal and child health organizations to create an international database of already completed studies pertaining to the physical and developmental environment of high-risk infants.
The group is coming up with recommendations for changes in NICU design and care practices to improve the outcome of infants. Recommendations on sound and auditory development will be completed next month. Another report on light and its effects is due out this spring. Other recommendations will deal with sleep, smell and taste, and movement and positioning of the premature infant.
Some preliminary recommendations have already been incorporated into guidelines for perinatal care and architectural standards for the design of NICUs. They include:
ï Remove the large bank of overhead lights typical in many NICUs and design individual controls for lighting at each infant's incubator. Studies have shown intense light may damage the developing retina.
ï Vary ambient light levels to mimic natural cycles, which can help improve the infants' sleep patterns.
ï Reduce background noise to no more than 50 decibels so babies can hear parents' and nurses' voices. Continuous loud noises can interfere with the infant's ability to distinguish speech patterns and tone, and may slow language development, Dr. Graven said.
Noise can be controlled by using alarms that flash instead of buzz, changing to vibrating pagers, muffling sounds made by metal trash cans and carefully controlling the acoustic qualities of a unit's design and equipment, he said.
The comprehensive study directed by Dr. Graven began in 1982 and has been funded by more than $800,000 from the U.S. Public Health Service, in cooperation with the National Institute of Child Health and Human Development and the National Institute for Nursing Research.
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