Sensory exposure of neonates in single-room environments (SENSE): an observational study of light

ObjectivesTo measure the internal and external light exposure of incubators and open cots in an Australian single-room configured neonatal unit and compare findings to current recommendations.MethodsLight meters were placed in the internal and external environment of incubators and open cots within occupied single rooms in a tertiary-level neonatal unit between 15 September and 28 October 2015. Data were recorded in one-second increments over a minimum of 48 hours per room.ResultsInternal median light in incubators and open cots predominantly fell below 50 lux, with low amplitude diurnal cycling. Incubator covers substantially reduced external light exposure, contributing to very low light conditions (<10 lux). Periodically, light inside incubators peaked six times greater than the maximum recommendation of 600 lux. Overall, internal incubator and open cot lighting in the neonatal unit met American Academy of Pediatrics and American College of Obstetricians and Gynecologists recommendations for 65.1% of the time during the day and 25.6% overnight. Australasian Health Infrastructure Alliance recommendations were met for 6.7% of the time during the day and 2.4% overnight.ConclusionsOverall, light levels fell predominantly below 50 lux with peak periods of extreme light exposure. Low amplitude cyclic light was evident, but it remains unknown if this is sufficient to produce an effect on circadian entrainment, especially in preterm neonates. Current guidelines do not stipulate optimal cyclic light levels in neonatal units to promote circadian rhythms in the newborn population. Further research to determine well-defined lighting parameters for neonates of different gestations is paramount.

O uso de tecido flanelado sobre incubadoras: repercussão nos níveis de ruído/The use of incubator covers: repercussion on noise levels

Avaliar a efetividade do uso de um tecido flanelado sobre a cúpula das incubadoras na diminuição do nível de pressão sonora (NPS) decorrente da presença do pulso oxímetro e da bomba de infusão em funcionamento e seus alarmes soando. Estudo quase-experimental em que foram mensurados os níveis de pressão sonora de 20 incubadoras, divididas em três grupos conforme a marca, modelo, tempo de uso, com os equipamentos em funcionamento e como soar dos alarmes sobre suas cúpulas, com e sem tecido flanelado. Ao soar o alarme do pulso oxímetro, somente no grupo 1 houve redução significativa dos níveis com o uso do tecido. O uso do tecido aumentou significativamente os níveis produzidos pelo funcionamento da bomba de infusão nos grupos 1 e 3. Ao soar do alarme da bomba de infusão, houve redução significativa de níveis com o uso do tecido nos grupos 2 e 3. Conclui-se que o uso do tecido flanelado, embora tenha reduzido os níveis em algumas situações, não atingiu níveis sonoros seguros e não deve ser utilizado como estratégia de redução de ruído e os equipamentos não devem permanecer sobre a cúpula.

Light Reduction Capabilities of Homemade and Commercial Incubator Covers in NICU

Reduction of high-risk neonates’ exposure to aversive light stimulation is an important component of developmentally supportive care. In neonatal intensive care unit (NICU), usually light is reduced by reducing the room’s light level or by using incubator covers. Many types of incubator covers are in use, including homemade and commercial covers. A comparative study was used to determine the light reducing capabilities of 19 homemade incubator covers, 2 commercial covers, and 1 receiving blanket. The covers were tested by covering and uncovering an incubator and an oxygen hood in the NICU during daytime and nighttime lightings. The light reducing capabilities value was determined for each cover using an Extech light dosimeter when the cover was placed over and removed from an oxyhood, and an incubator. The study showed that the light reducing capability of the commercial covers was 91.2%, the homemade covers capability was 72.1%, and the receiving blankets capability was 55.1%. A significant difference between the commercial and homemade covers was found (F=452.50, P<0.00). Commercial incubator covers are the most effective covers to achieve light reduction; homemade covers can be effective if made large enough so that they completely cover all sides of the incubator.

A Comparison of the Light- Reduction Capacity of Commonly Used Incubator Covers

Purpose: The use of incubator covers to enhance preterm infants’ rest and recovery is common in the NICU. However, the kinds of covers used vary extensively among and within nurseries. Few data exist on the effectiveness of different types of covers in reducing light levels to the infant. This study compared several types of commonly used incubator covers as to efficacy of light reduction.Design: A descriptive, comparative design was used in this study.Sample: Twenty-three incubator covers were tested, including professional, receiving blanket, hand-crocheted, three-layer quilt, and flannel.Main Outcome Variable: The percentage of light level reduction of different incubator covers under various ambient light level settings.Results: The amount of light reduction provided by incubator covers varies depending on type of fabric as well as percentage of incubator surface shielded by the cover. Dark-colored covers provided greater light reduction than bright/light-colored covers when covers identical in fabric type were compared. The light-reduction efficiency of the covers varied depending on the level of ambient light. Covers provided less light reduction in higher ambient light levels.