Neonatal intensive care unit (NICU) settings present neonates with many environmental hazards, including exposure to dangerous sound intensity levels. Noise levels in NICUs worldwide overwhelmingly exceed the recommendations for safe exposure by the American Academy of Pediatrics. Environmental modifications and staff behavioral changes have proved ineffective to sufficiently reduce infant noise exposure. A systematic review of the literature was undertaken to answer if earmuffs improves physiologic stability, behavioral response, and sleep behavior, which are markers of stress response in NICU patients. Seven databases were searched for pertinent records using a specific search protocol. Seven studies met the review’s inclusion criteria and were examined for qualitative synthesis. This review supports using earmuffs to reduce neonate exposure to noise in the NICU as a viable intervention to improve physiologic stability and sleep and behavioral responses. Earmuffs are a minimally invasive, affordable, and effective option for attempting to comply with recommended noise guidelines. Moreover, earmuff use by NICU patients should be considered as a component of routine evidence-based practices when implementing development-centered care to minimize over-stimulation of NICU patients.

MS1068_Author Responses to Decision.docx (181 kB)
Author responses to copy editor