Families' views upon experiencing change in the neonatal intensive care unit environment: from the ‘baby barn’ to the private room

Abstract

Background: Parents whose newborns were cared for in the old neonatal intensive care unit (NICU) environment and then moved to the new NICU environment describe their impressions of the impact upon their infant's care, information access and support, of the two care settings.Objectives: To determine the perceptions of parents in the NICU regarding noise, light, space, access to caregivers and personal privacy as they experience both old and new NICU environments in the continuum of care for their infant.Methods: In the first 9 months after moving into the new private room NICU, a convenience sampling of parents was voluntarily administered a 20-question Likert scale survey addressing length of stay (LOS) in the respective NICU environment, environmental stimuli, access to caregivers, access to information and personal privacy. Scores reflect frequency of perceptions as never ¼ 1, sometimes ¼ 2, usually ¼ 3 and always ¼ 4.Results: The responses of 53 parents are reported. This represents 10% of admissions to the private room NICU during the 9-month sampling time. Fifty-nine percent had LOS of p14 days in the old NICU before moving; 76% had LOS p14 days in the new NICU before completing this survey. Median scores for the major content themes are reported (New:Old). Responses suggest that in the new vs old design, parents feel they are able to spend more time with their infant (4:3); have more privacy (4:2) and space for their personal items (4:1); experience less overstimulation with noise and light (1:2); had comparable access to their infant's nurse (4:4) but greater access to their infant's doctor (3:2); and felt comparably informed (4:4) but better supported by the entire team (4:3). Conclusions:The new private room NICU is perceived by parents to offer an enhanced environment that is more spacious and less overstimulating for their infant and themselves. Access to professional caregivers, information and overall support appears to be improved in the new environment despite a larger overall NICU area, floor plan and structural layout.

Mothers' Experiences Expressing Breast Milk for Their Preterm Infants

“…This finding was surprising, as increased privacy has been cited in several studies 21,26,27 as a primary benefit of SFR NICUs. Mothers pointed out that although they were in a private room they could not control who entered and so the potential that they could be interrupted while pumping made the mothers uncomfortable.…”

“…Staff perceived that parents were afforded greater privacy in SFR 21,22,26 and this was consistent with the perceptions of parents that SFR afforded better privacy for bonding and breastfeeding 25 and overall privacy. 26,27 A recent study 20 found that infants in an SFR NICU had significantly longer total days of receiving mothers' breast milk when compared to infants in a standard open-bay unit NICU. However, no studies were located that examined the potential effect of the enhanced privacy on mothers' perceptions concerning milk expression in an SFR NICU.…”

From bedlam to bedroom: almost there?

“…A previous study 2 as well as a large body of anecdotal information has demonstrated that families are more satisfied in private rooms, but are challenged by the isolation this setting imposes upon them. Caregivers, too, recognize that an SFR design improves the sensory environment for newborns and is more desirable for families, but creates communication and collaboration impediments for both families and staff that are not found in open, multi-bed rooms.…”

Single-Family Room Care and Neurobehavioral and Medical Outcomes in Preterm Infants

“…Although there are few studies comparing these 2 models of care, most have reported beneficial effects of the SFR NICU. These include a shorter interval until full enteric feedings; fewer apneic events; reductions in mortality, nosocomial sepsis, 2 length of stay, [3][4][5] rehospitalization, 4 cost, 6 and noise; increases in breastfeeding, 2 family-centered care, parent visitation, privacy and satisfaction 3,[6][7][8] ; more positive staff perceptions of the environment 2 and job quality 9 and less nurse anxiety. 10 However, negative effects have also been reported including increased number of staff, 10 poorer quality of staff interaction, 9,11 and increased maternal stress.…”