Clinical research data illuminating the relationship between the physical environment & patient medical outcomes.

The past 8 to 10 years have produced a large amount of information on the sensory development of the preterm infant. As a result of this information, it is evident that many of the environmental factors and care practices in the NICU do have a significant impact on infant sensory development. The factors that relate to light and noise clearly can be technologically modified to adapt better to infants' needs. Lights can be individually controlled. Focused lighting with limited scatter can be used, and a variety of techniques are available to produce barriers between light and the infant. Sound reduction and noise control in the NICUs are a constant problem. Much of the noise is generated by personnel. Much of it, however, is not essential and can be controlled. While the sound levels of the nursery do not produce any form of hearing loss, as measured by traditional hearing tests, it is now clear that they have the capacity to interfere with frequency discrimination and pattern recognition. These effects have been demonstrated in a wide range of animals and are currently under study in humans. The problems of sleep deprivation are very much tied to care practices and NICU organization. Again, the evidence supports the need for extended periods of undisturbed sleep in infants at all levels of maturity. This requires active involvement of the staff and the development of care plans and practices that allow infants clear rest periods undisturbed.