72 - A Quality Improvement Project - Providing Music Therapy to premature babies in the Neonatal Intensive Care Unit

Poster Number: 72
Publication Number: 72.3020

Background: NICU infants are exposed to high-pitched sounds not physiologically aligned for the development. Preterm infants require adequate positive auditory stimulation. Music is helpful in decreasing heart rates, stress, and salivary cortisol level. It improves nonnutritive sucking, oxygen saturation, weight gain and reduces duration of NICU stay. In developing a Music Therapy (MT) program for the NICU, the type, volume and duration of music-all must be considered. Mozart music helps improve cognition, mood, and decrease resting energy expenditure in neonates. Recorded music is also beneficial if live music is unavailable.

Objective: To provide Music therapy to premature babies (GA < 32 weeks) admitted to Jack D Weiler NICU who are hemodynamically stable, on respiratory support ≤30% FiO2 and ≤CPAP +6 cm H20, and on full enteral feeds.
SMART

Aim: 50% of eligible infants will receive MT by June 2023.

Design/Methods: NICU staff was educated about music therapy and trained to use MT instrument.
Recorded Mozart music was played by a speaker, 3 times/week, 30-minute session at volume of 65 to 70 dB ( sound meter used to monitor volume). Speakers were kept at an appropriate distance from infant (30 cm from ear).
Outcome measured: percentage of eligible infants who received music therapy even one time.
Secondary outcome: percentage of music therapy sessions successfully provided to eligible infants.
Plan-Do-Study-Act (PDSA) methodology was used to solicit feedback and identify and implement process measures for improvement
Balancing measures: Premature termination of MT due to clinical instability in the form of apnea, bradycardia, desaturation, vomiting.

Results: A total of 54 infants received MT from Dec 2022- Oct 2023.
Average Birth GA of the infants on MT: 28.24 weeks, average PMA at start of MT: 33.6 weeks, MT was provided till average age of 37.7 weeks.
Percentage of eligible infants receiving at least one session of MT increased from 50% in first month to 100% (Fig 3). 
The average percentage of music therapy sessions received per infant is 44.5%.
76.7% nurses identified no barriers to provide MT when surveyed.

Conclusion(s): Recorded MT can be effectively provided in NICU to all eligible babies. 
Continuous multidisciplinary efforts are required to sustain efforts to provide complete MT sessions to eligible infants. 
Music Therapy is perceived positively by the NICU staff for its overall benefits.