Documenting the NICU design dilemma: comparative patient progress in open-ward and single family room units

R Domanico, D K Davis, F Coleman, B O Davis, R Domanico, D K Davis, F Coleman, B O Davis

Abstract

Objective: To test the efficacy of single family room (SFR) neonatal intensive care unit (NICU) designs, questions regarding patient medical progress and relative patient safety were explored. Addressing these questions would be of value to hospital staff, administrators and designers alike.

Study design: This prospective study documented, by means of Institution Review Board-approved protocols, the progress of patients in two contrasting NICU designs. Noise levels, illumination and air quality measurements were included to define the two NICU physical environments.

Result: Infants in the SFR unit had fewer apneic events, reduced nosocomial sepsis and mortality, as well as earlier transitions to enteral nutrition. More mothers sustained stage III lactation, and more infants were discharged breastfeeding in the SFR.

Conclusion: This study showed the SFR to be more conducive to family-centered care, and to enhance infant medical progress and breastfeeding success over that of an open ward.

References

    1. Lackritz E. Chief, Maternal and Infant Health Branch, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention U.S. Senate Sub-committee Report. 2004.
    1. Conner JM, Nelson EC. Neonatal intensive care: satisfaction measured from a parent's perspective. Pediatrics. 1999;103 (1:336–349.
    1. Floyd AMD. Challenging designs of neonatal intensive care units. Crit Care Nurse. 2005;25 (5:59–66.
    1. White RD. Individual rooms in the NICU—an evolving concept. J Perinatol. 2003;23 (Suppl 1:S22–S24.
    1. Stevens DC, Helseth CC, Khan MA, Munson DP, Smith TJ. Neonatal intensive care nursery staff perceive enhanced workplace quality with the single-family room design. J Perinatol. 2010;30 (5:352–358.
    1. Domanico R, Davis DK, Coleman F, Davis BO., Jr Documenting the NICU design dilemma: parent and staff perceptions of open ward versus single family room units. J Perinatol. 2010;30 (5:343–351.
    1. Oelrich T. Single Room NICU: Fad or Future. AIA Academy of Architecture for Health Conference: Denver, CO; 2003.
    1. Rosenblum D. Single Family Room Care: Before and After Data. The Physical and Developmental Environment of the High-Risk Infant Conference: Clearwater, FL; 2005.
    1. Gray JE, Richardson DK, McCormick MC, Workman-Daniels K, Goldman DA. Neonatal Therapeutic Intervention Scoring System: a therapy-based severity-of-illness index. Pediatrics. 1992;90 (4:561–567.
    1. Wielenga JM, Smit BJ, Unk LKA. How satisfied are parents supported by nurses with the NIDCAP model of care for their preterm infant. J Nurs Care Qual. 2006;21 (1:41–48.
    1. Lawerence R.Breastfeeding: A Guide for the Medical Professional6th edn.Elsevier/Saunders: Philadelphia, PA; 2005
    1. Als H, Lawhon G, Duffy FH, McAnulty GB, Gibes-Grossmal R, Blickman JG. Individualized developmental care for the very low birth-weight preterm infant. JAMA. 1994;272 (11:853–858.
    1. Altimer LB, Eichel M, Warner B, Tedeschi L, Brown B. Developmental care: changing the NICU physically and behaviorally to promote patient outcomes and contain costs. Neonatal Intensive Care. 2005;18 (4:12–16.
    1. White RD. Recommended standards for newborn ICU design. J Perinatol. 2006;26:S2–S18.
    1. White RD. Recommended standards for the newborn ICU. J Perinatol. 2007;27:S4–S19.
    1. Kruegar C, Wall S, Parker L, Nealis R. Elevated sound levels within a busy NICU. Neonatal Netw. 2005;24 (6:33–37.
    1. Gray L, Philbin MK. Effects of the neonatal intensive care unit on auditory attention and distraction. Clin Perinatol. 2004;31:243–260.
    1. Graven SN. Early neurosensory visual development of the fetus and newborn. Clini Perinatol. 2004;31:199–216.
    1. Rivkees SA. Emergence and influences of circadian rhythmicity in infants. Clin Perinatol. 2004;31:217–228.
    1. Miller CL, White R, Whitman TL, O'Callaghan MF, Maxwell SE. The effects of cycled versus noncycled lighting on growth and development in preterm infants. Infant Behav Dev. 1995;18:87–95.
    1. Gewolb DC, Vice FL. Maturational changes in the rhythms, patterning, and coordination of respiration and swallow during feeding in preterm and term infants. Dev Med Child Neurol. 2006;48 (7:589–594.
    1. Barlow SM. Oral and respiratory control for preterm feeding. Curr Opin Otolaryngol Head Neck Surg. 2009;17:179–186.
    1. Ferber SG, Makhoul IR. The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: a randomized, controlled trial. Pediatrics. 2004;113 (4:858–865.
    1. Saiman L. Risk factors for hospital-acquired infections in the neonatal intensive care unit. Semin Perinatol. 2002;26 (5:315–321.
    1. Adams-Chapman I, Stoll BJ. Prevention of nosocomial infections in the neonatal intensive care unit. Curr Opin Pediatr. 2002;14:157–164.

Source: PubMed

3
Subskrybuj