Noise in neonatal care: Findings from a thematic analysis of free-text survey data

Abstract
Purpose
Noise levels in neonatal units (NNUs) often exceed recommended limits. This study aimed to explore neonatal staff experiences and opinions regarding noise in NNUs across Wales and to identify perceived barriers and facilitators to noise reduction.
Methods
A professional opinion survey was distributed to staff in the nine NNUs in Wales. Free-text responses were analysed inductively using reflexive thematic analysis.
Results
Respondents perceived excessive, sudden, or unpredictable noise as detrimental to infants, disrupting sleep, feeding, and physiological stability, contributing to stress, fatigue, and impaired concentration, raising concerns about patient safety. Themes highlighted a prevailing culture of noise, limited self-awareness among staff and visitors, environmental contributors, and a need for stronger leadership and education. Suggested interventions included quiet times, visual cues, and education.
Conclusions
Noise is a modifiable environmental stressor affecting babies, families, and staff. Reducing noise requires cultural change, leadership engagement, and ongoing education. This study can inform policy, training, and quality improvement initiatives.