Clinical Trial Results

Music for NICU Nurses: A QI Project

Location
Loma Linda University Children’s Hospital
84-bed, Level IV Neonatal Intensive Care Unit (NICU) in Loma Linda, CA

QI Coordinators
Mehling Dew, RN – Chairperson, Neuroprotective Core Measure 1: The Healing Environment
Sandra Mitchell, RN – Coordinator, Neuroprotective Care Program
Raylene Phillips, MD, FAAP, FABM, IBCLC – Medical Director, Neuroprotective Care Program

Purpose
To determine the effect of carefully modulated, soothing music to decrease the stress level of NICU nurses by creating a more relaxed environment just prior to nursing shift change.

Intervention
Music that was psycho-acoustically designed to reduce stress and promote relaxation was played in NICU rooms for 20 min prior to shift change. Each room had 6-8 babies with 3-4 nurses. The music was played at a sound level of no greater than 55 dB. For each data collection event, 3 rooms were monitored. In one room, the music included instrumental and vocals. In a second room, the same composition included only instrumental music. In the third room, no music was played (as a control). Data collection events occurred on both day and night shifts.

Outcome Measures
A questionnaire was given to nurses to rate their stress level before and after the music, ability to accomplish their work, and overall impression. Vital signs of babies in the room were monitored before, during and after the music.

Results
In the rooms where music was played, surveyed nurses indicated a 44% reduction in stress level compared to an 8% reduction in stress level in rooms where no music was played. Vital signs of babies were stable and showed no adverse effect. A majority of nurses (68%) reported the music enhanced their work and none reported the music interfered with their tasks. Nurses reported a preference for instrumental music with no vocals.

Nurses’ Comments
Music was pleasant to hear. It helped me to relax while caring for babies,
Love the music. It makes the working place calm and soothing. It is a nice change or addition from listening to the alarms and and crying and overhead noise.
I think it made the babies calmer and vital signs more stable.
Enjoyed the music. I feel that it provides a relaxing with calming environment to both babies and nurses alike.

Acknowledgements
A special thank you to Lisa Rafel, composer/singer and to Gary Malkin, composer/performer