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Debra D. Harris, Ph.D., Principal Investigator, University of Florida, Gainesville, FL Mardelle McCuskey Shepley, Co-Investigator, Texas A&M University, College Station, TX Robert White, M.D., Co-Investigator, Memorial Hospital, South Bend, IN

Context

Recent technological advancements have resulted in an increase in the NICU population. Children who might have died five years ago are today surviving and are having extended stays in NICUs. Because of the increased use of NICUs, many hospitals are expanding or adding neonatal services, resulting in new construction, remodeling of facilities, and experimentation with innovative nursing models and facility design.

Objective

To explore the implications of the single family room (SFR) care environment of neonatal intensive care units (NICU) compared to Open-bay, Combination and Double-occupancy configurations, focusing on family experience, neonate outcomes, staff perceptions, cost and environmental design.

Methodology

The settings for this research include 11 single family room, open-bay, combination, and double occupancy Level III NICUs across the United States. The research design used several methods. Plan reviews, site visits, and post occupancy evaluations assessed the physical environment and impacts on the users. Construction cost data were evaluated based on adjusted to 2005 values and normalized to the National City Average. Anonymous personal health information was collected to compare patient medical outcomes including average daily census, average length of stay, and nosocomial infection rates. Surveys for NICU medical staff and parents explored the preferences and experiences of those providing and receiving care in 2 of the participating facilities; 1 facility was an SFR NICU, and the other was a combination unit with open-bay infant stations and SFRs.

Results

Based on the results of this initial comprehensive study, single family room NICU design provides solutions for increasing parent privacy and presence, supporting HIPAA compliance, minimizing the number of undesirable beds, increasing staff and parent satisfaction, and reducing nursing staff stress. Potential limitations of the SFR design are reduced parent-to-parent social contact and isolation of both parents and staff. In the projects reviewed in this study, construction cost was not influenced by design configuration; therefore, the decision to provide SFR units should not be influenced by financial implications. The provision of single family room units should be seriously considered when creating an NICU; if this is not possible, a combination of both SFR and open- bay units is recommended.

Expertise Provided: Independent Research + Facility Evaluation