Original Article

Cognition, Technology & Work

, Volume 15, Issue 3, pp 329-345

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

A quiet NICU for improved infants’ health, development and well-being: a systems approach to reducing noise and auditory alarms

  • A. FreudenthalAffiliated withFaculty of Industrial Design Engineering, Delft University of Technology Email author 
  • , M. van StuijvenbergAffiliated withDepartment of Neonatal Intensive Care, Beatrix Children’s Hospital, University Medical Centre Groningen
  • , J. B. van GoudoeverAffiliated withDepartment of Pediatrics, Emma Children’s Hospital, VU University Medical Center and Academic Medical Center


Noise is a direct cause of health problems, long-lasting auditory problems and development problems. Preterm infants are, especially, at risk for auditory and neurocognitive development. Sound levels are very high at the neonatal intensive care unit (NICU) and may contribute to the frequently observed detrimental outcomes of prematurely born infants. Despite efforts to reduce noise level at the NICU, these have not changed over the past years. Although many authors indicate that a systems approach could solve such interrelated problems, methods to do so are generally lacking for the complicated situation in a critical care setting. A new approach was developed, that is, combining Fuzzy Front End earliest stage product development and human factors methods, with a focus on all Human-tech levels and on their interaction. A concept built up from several emerging technologies was developed, including tactile alarms, artificial intelligence for medicine, multimodal alarm system and mobile communication in critical care. Current and envisioned nursing work was modelled. Outcome of the study is an overview of investigations to develop the measures.


User interfaces Ergonomics Behaviour Medical systems Alarm handling System design