Describing sound levels in Australia’s highest acuity paediatric intensive care unit

Paediatric intensive care has shifted beyond survival to ensuring quality recovery and reducing long-term harm. Each year, more than 10,000 Australian children are admitted to a paediatric intensive care unit (PICU).

With improvements in medical technology, attention is turning to modifiable environmental factors that shape how children heal within intensive care settings. One factor is the auditory environment of the PICU – including high noise levels from monitors, alarms and staff activity.

Excessive and unpredictable sound is increasingly recognised as contributing to poor sleep, stress and delirium. However, little is known about what children in the PICU actually hear. Currently, there are no contemporary Australian data describing the sound exposure of critically ill children. Without accurate data, it is impossible to design effective strategies to reduce harmful noise or promote a healing environment.

This study will provide detailed measurement of bedside sound in Australia's highest-acuity PICU at The Royal Children's Hospital Melbourne. Using 24-hour sound recordings from 50 children, the research team will map average, peak and night-time sound levels and explore links with patient acuity, ventilation and comfort, to establish benchmark data informing future interventional studies.

The team aims to:

• Describe sound levels children are exposed to during standard patient care across 24 hours
• Define peak and minimum sound levels
• Compare sound levels according to ventilation type
• Compare measured levels with recommended World Health Organisation (WHO) guidelines
• Explore associations between sound and clinical or procedural events.

MDAP's expertise is essential for managing high-volume, high-frequency datasets. MDAP will support integration of sound data with relevant clinical variables, creating curated and secure datasets for efficient analysis and sharing.

Beyond data management, MDAP will contribute advanced analytic and visualisation capability to identify sound patterns, peaks and event-related variability that conventional methods cannot discern.

The project will produce foundational Australian data on paediatric intensive care sound exposure, filling a major gap in the literature and informing subsequent cohort and interventional studies. Findings will inform quality improvement initiatives, staff education, and hospital design standards that support safer, calmer intensive care environments that optimise stress reduction and patient and family wellbeing.