Background/Objectives: Adaptation to extrauterine life is challenging for preterm newborns. Environmental stimuli, such as noise, can lead to adverse health outcomes, causing instability of vital parameters and impairment of neurodevelopment. The American Academy of Pediatrics recommends a maximum environmental noise level of 45 decibels (dB) or less in the NICU. The study’s primary aim was to describe environmental noise in a neonatal intensive care unit and to analyze potential associations between noise and vital parameters of preterm newborns, including heart rate, respiratory rate, and oxygen saturation levels. Methods: A pilot observational feasibility study was conducted in a level III NICU. Sound levels and vital parameters were recorded over four hours for each preterm newborn. Confounding variables were controlled. Data were analyzed using descriptive statistics, Kendall’s τ-b, and logistic regression analysis. Ethical approval and parental consent were obtained. Results: The average environmental noise level was consistently above 45 dB. Six patients were enrolled, and 22 recordings (ranging in length from 1 to 4 h) were performed. Data adjusted for confounding variables show a statistically significant Kendall’s correlation between heart rate and decibels (τ-b = 0.89, p = 0.003, n = 520), suggesting a monotonous crescent tendency between these two variables, although the relationship is not strong. The logistic regression model indicates that the odds ratio (OR) for decibels related to tachycardia is 1.066, meaning that for each 1 dB increase, the probability of tachycardia rises by 6.6% (p < 0.001). Conversely, the OR for respiratory rate is 0.959, suggesting that for each unit increase in respiratory rate, the probability of tachycardia decreases by approximately 4.1% (p < 0.001). Conclusions: The study reveals that the mean environmental noise level in the NICU consistently exceeds the recommended safety level. Decibels are one of the significant variables contributing to the likelihood of tachycardia, and an increase in decibels has a significant effect on this, but it is not the only one. Further analysis of a larger sample is needed.

Introduction. Adaptation to extrauterine life is challenging for preterm babies. Environmental stimuli, like noises, could lead to adverse health outcomes, causing instability in vital parameters and neurodevelopment impairment. American Academy of Pediatrics recommends a maximum environmental noise ≤ 45 decibels (dB) in the Newborn Intensive Care Units (NICUs). We hypothesise that listening to white noises and parental voices could mitigate the adverse outcomes caused by noises > 45 dB on preterm babies. Methods. A randomised controlled trial (ClinicalTrials.gov, NCT06150404) aimed to include preterm babies of ≥31 weeks gestation, meeting the specific inclusion criteria. Data regarding environmental noises and vital parameters will be collected from all patients enrolled from the day of enrollment till their discharge. In addition, data regarding language and hearing development will be collected respectively after three years and three months from discharge. A soundtrack with white noises and parental voices will be administered to preterm babies enrolled in the intervention group through an mp3 device. Expected Results. If our hypothesis is confirmed, this study could benefit preterm babies by reducing adverse outcomes linked to excessive environmental noise, such as vital parameters instability and language and hearing impairment. Study results could also affect care practices in NICU settings to ensure patient safety, even if the null hypothesis is confirmed. The data collected will be utilised to understand environmental noise levels in our NICU and implement improvement projects in their management.

Background/Objectives: In recent years, some hospitals have shifted from traditional to intensity-of-care-based organizational models, where patients allocation is based on the care they require. In this context, Nursing Patient Classification Systems (NPCSs) can lead to the identification of the appropriate nursing care setting based on patient nursing needs; this also applies to pediatrics. In this scenario, the concept of patient nursing complexity has emerged. This narrative literature review aims to provide an overview on validated NPCSs that assess the nursing complexity of pediatric patients. Methods: PubMed, CINAHL, and the Cochrane Library were searched, and inclusion and exclusion criteria were applied to the retrieved papers. Two authors independently screened n = 498 papers, of which n = 7 were read in full and subsequently excluded. Results: No paper met the inclusion criteria. However, papers read in full were analyzed, and their main characteristics were described. They were excluded because they did not concern validated NPCSs that assess pediatric patients’ nursing complexity or did not assess pediatric patients’ nursing complexity as defined in this literature review. Conclusions: This narrative literature review highlighted a critical gap in the field of validated NPCSs that assess the nursing complexity of pediatric patients. The lack of a shared definition of “nursing complexity of the patient” is the primary barrier identified. This constitutes a crucial take-home message. Therefore, future studies should prioritize in-depth exploration of the differences among all the published definitions and concepts related to “complexity” and harmonizing existing conceptual analysis to guide future research and the development of shared NPCSs.

Purpose: Nurse professionals often practice rectal stimulation in a hospital setting to help premature or full-term babies evacuate or to avoid abdominal pain caused by gas colic. Paediatricians also recommend this technique to newborn caregivers, who can carry it out independently at home. To the best of our knowledge, there are no established national guidelines on how to implement this technique safely or what the clinical/care indications are for its use. Our purpose is to synthesise the evidence on the nursing practice of rectal stimulation in preterm and full-term newborns. Methods: A narrative literature review was conducted. A search was conducted across six databases in February, followed by a manual review of the included studies’ bibliographies, and another search in October 2023. The search strategy identified studies published without date limits. The articles were screened according to the inclusion criteria. Results: Sixty-two articles were retrieved. Following the screening process, only two articles were selected for inclusion in the final synthesis. Both studies evaluated the effects of enemas and/or rectal stimulation on feeding tolerance and bowel habits in preterm newborns. Even if both studies included information on when rectal stimulation in preterm newborns is indicated and how it is conducted, they are insufficient to provide a clear statement for nursing practice. Conclusions: Nowadays, nurses perform rectal stimulation and teach it to caregivers of newborns without shared international or national guidelines or procedures focused on patient safety. It is desirable to conduct scientific studies to inform nursing practice and enhance the quality of nursing care delivered. This review also highlights a critical gap in evidence regarding the use of rectal stimulation in full-term newborns and in community settings.

Introduction: the design of neonatal and paediatric neonatal intensive care significantly impacts the outcomes of the families, workers, and organizations. The aim of this review is to identify the effects of the introduction of the single-family room in neonatal intensive care and paediatric intensive care on the outcomes of paediatric patients, families, staff, and organizations. Materials and Methods: we structured this work as a systematic review, registered on PROSPERO (CRD42024501520). This review has been developed using Joanna Briggs Institute recommendations. The database search will include PubMed, CINAHL, SCOPUS, EMBASE, PsycINFO, Web of Science. Documents published in English, Italian and Spanish from 2009 will be included. Results: the results of this review will provide insights on the effects of the introduction of single-family room assessment. This could help nursing stakeholders to effectively evaluate and eventually plan the transition to single-family room assessment to ensure quality of care, user and staff satisfaction. Discussion: the introduction of single-family room structure plays a pivotal role in family involvement and active participation in their child’s care. Also, this requires modifications in healthcare professionals’ way of approaching and planning patient care. Considering the importance and the substantial changes that single-family room could bring to patients, families, staff and organizational outcomes, this review may provide important insights for the introduction of single-family room on patients, families, staff, and organizations building a rationale on the introduction of this new organizational structure.