Staff Nurse, Infection Prevention Coordinator Boston Children's Hospital Melrose, Massachusetts, United States
Abstract:
Introduction: Newborns who require intensive care at birth have experiences that may adversely affect their neurodevelopment. The loud, bright, and disruptive environment and caregiving activities associated with critical care create stressors for this vulnerable population. Research has demonstrated that music can positively impact neurodevelopmental and clinical care in the neonatal intensive care unit (ICU). Newborns in the cardiac ICU (CICU) experience similar stressors, but music therapy has not been widely studied in that population. We explored the feasibility of implementing nurse-led music therapy in a cohort of newborns admitted to the CICU post congenital heart surgery.
Methods: Neonates scheduled for cardiac surgery were eligible to participate in the study. Lullabies with soothing characteristics were pre-recorded by music therapists. At least 24 hours after surgery, once hemodynamic stability was achieved, music therapy was initiated. Music played for 20 minutes, during a rest period, twice a day while intubated, for up to 14 days. Several metrics were recorded surrounding the music therapy intervention. Nurses were asked about the ease of initiating therapy and parents were invited to complete a survey exploring their perception and satisfaction with the music therapy.
Results: Ten subjects were enrolled to receive nurse-led music therapy. One patient could not receive music therapy because of the location of the bed in an open bay where extraneous noise could not be limited, and one failed to complete the music study due to clinical deterioration unrelated to music therapy. Nurse-led music therapy was initiated in 44 of the 50 (88%) eligible shifts in the eight subjects who successfully completed the study. Reasons that the music therapy was not initiated during an eligible shift included unexpected procedures (2, 4%), background noise levels too high (2, 4%), equipment difficulty (1, 2%), and lack of knowledge (1, 2%). Physiologic status of subjects remained stable throughout the music therapy sessions and no adverse events occurred. All nurses (100%) reported that the music therapy was easy to administer. Six parents who completed the survey "Agreed" or "Strongly Agreed" that they were satisfied with the music therapy provided to their baby, that the music therapy had a beneficial/positive effect on their baby, that they enjoyed listening to the music, and that they would like the opportunity to play music for their baby while in the hospital.
Conclusion: Newborns with congenital heart disease who require intensive care at birth are at risk for neurodevelopmental delays. Despite the critical nature of caring for newborns in the CICU, nurse-led music therapy is feasible in hemodynamically stable newborns recovering from cardiac surgery. This knowledge presents an opportunity for further study to determine if nurse-led music therapy can positively affect the neurodevelopment and clinical care of newborns in the CICU.
