12th World Congress on
Pediatrics & Neonatology

Dr. Suhe Zhang

National University Hospital, Singapore

Abstract Title:

It Is Too Loud for My Tiny Ears!

Biography:

Ms. Suhe Zhang is a Senior Nurse Clinician and Advanced Practice Nurse in the Neonatal Intensive Care Unit at the National University Hospital, Singapore, with more than 25 years of experience in neonatal nursing. She is a strong advocate for neurodevelopmental care and pioneered the implementation of evidence-based Kangaroo Care practices within her unit, establishing standards that continue to benefit premature infants and their families. Ms. Zhang obtained her Master of Nursing (Pediatrics) from the National University of Singapore in 2017 and is the first pediatric-trained Advanced Practice Nurse to serve in the Neonatal Unit. Her clinical expertise includes the management of stable, growing preterm infants, facilitating complex care transitions, and providing outpatient follow-up care for newborns. She also leads the Home Equipment Loan Program, a quality improvement initiative that enhances the safety and efficiency of neonatal discharge planning. Ms. Zhang is dedicated to improving outcomes for vulnerable newborns through compassionate, evidence-based, and family-centered care.

Research Interests:

Background: The American Academy of Pediatrics recommends that noise levels in neonatal care settings should not exceed an average of 45 decibels (dB). Excessive noise poses significant risks to the health and neurodevelopment of premature infants, including physiological stress, sleep disruption, and behavioral instability. Noise levels in the Neonatal High Dependency Unit are often elevated due to high patient density, spatial constraints, and the unit's physical layout. Interventions such as music therapy may help mitigate the impact of ambient noise by providing structured, developmentally appropriate auditory stimulation that supports infant well-being while reducing parental anxiety.

Aim: This evidence-based quality improvement project aimed to reduce environmental noise levels by 15%, from a baseline of 60–80 dB to 51- 68 dB, through targeted noise-reduction interventions and the integration of music therapy.

Methods: The project utilized the Plan-Do-Study-Act (PDSA) methodology to design, implement, and evaluate noise-reduction interventions. Compliance with best practices was assessed using a pre- and post-intervention design. Environmental noise levels were measured using a commercial digital sound level meter.

Results: The interventions included:
(1) education of healthcare personnel on the adverse effects of excessive noise on premature infants
(2) adjustment and standardization of physiological monitor alarm settings to reduce alarm volume
(3) implementation of pre-recorded classical lullabies accompanied by dimmed lighting during each nursing shift.
Following implementation, environmental noise levels decreased by 28.7%, from 60-80 dB to 52-63 dB Post-intervention audits demonstrated 100% compliance among nursing staff in incorporating music therapy into routine neonatal care.

Conclusion: This quality improvement initiative successfully increased awareness among healthcare professionals and caregivers regarding the detrimental effects of excessive noise on premature infants. The combination of targeted noise-reduction strategies and music therapy created a calmer, more developmentally supportive care environment. These interventions contributed to improved neonatal outcomes and enhanced parental satisfaction with the care experience.

Keywords: Noise Reduction; Music Therapy; Neonatal Care; Premature Infants; Quality Improvement.