The impact of single family room design on patients and caregivers: executive summary

Harris, Debra; Shepley, Mardelle McCuskey; White, Robert D.; Kolberg, Kathleen; Harrell, J. W.

doi:10.1038/sj.jp.7211583

Cited by 81 publications

(118 citation statements)

References 33 publications

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“…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. [3][4][5] In this issue, two studies using historical controls of multi-bed NICUs showed that moving to a new SFR NICU may improve staff perception of workplace quality (Stevens et al 6 ), but this is dependent to some degree on the type of caregiver and the length of time after the move during which the caregivers are surveyed (Domanico et al 7 ). Furthermore, the Domanico study showed that caregiver concerns must be considered subjective, as the perception that the safety of the infant might be compromised in the SFR could not be confirmed by increases in mortality or length of stay.…”

Section: Gustave Le Bonmentioning

confidence: 99%

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From bedlam to bedroom: almost there?

White

2010

J Perinatol

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As the science of neonatology advanced over the latter part of the 20th century, neonatal intensive care units (NICUs) did become happier places, with fewer codes and deaths. But they were hardly peaceful, becoming busier, brighter, noisier and far more complex. With the risk of death receding for most babies, concern over the effect of these stressors on infant neurodevelopment, the NICU experience and satisfaction of their families, and the physical and emotional health of their caregivers has grown. One reaction to this concern has been the recent surge in construction of NICUs with most or all of their bed spaces in single-family rooms (SFRs).That SFRs may be better for babies directly by reducing exposure to noxious sensory stimuli and the risk of nosocomial infection, and indirectly by increasing skin-to-skin care through encouraging parental presence and intimacy are attractive hypotheses. Studies on adults in private room settings have demonstrated benefits, 1 but randomized controlled trials of these questions in newborns are difficult to undertake when the intervention involves construction of a multi-million dollar facility. Alternative strategies include the use of historical controls, or, in cases where 'hybrid' units exist (which combine both private and multi-bed rooms), concurrent controls, although these methods have obvious shortcomings.Assessing the satisfaction of parents and caregivers after moving from an 'open' NICU to an SFR NICU is a more accessible question. 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. [3][4][5]

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Section: Gustave Le Bonmentioning

confidence: 99%

mentioning

confidence: 99%

From bedlam to bedroom: almost there?

White

2010

J Perinatol

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“…11,15 -17 This belief has coincided with a shift in new NICU construction away from the traditional OU design to NICU's with greater attention to acoustically favorable materials, and variable lay-outs, most notably, the single-family room (SFR) design. 18,19 These design modifications would be expected to favorably impact most factors contributing to overall sound levels within an NICU, which include the overall unit design, the acoustic qualities of the room (heating, air-conditioning and ventilation) and design-influenced modifications in human behavior and operational activity. However, the use of common NICU equipment is a noise variable that may remain significant despite the above improvements.…”

Section: Introductionmentioning

confidence: 99%

Comparing sound measurements in the single-family room with open-unit design neonatal intensive care unit: the impact of equipment noise

Liu

2011

J Perinatol

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Objective: To determine if measured sound levels in the occupied level 3 single-family room (SFR) neonatal intensive care unit (NICU) will be significantly and perceptibly different from the occupied level 3 open-unit (OU) NICU.Study Design: Case-control. Comparison of sound measurements obtained with varying types of respiratory support in SFR unit with measurements obtained from OU level 3 bedside NICU.Result: SFR sound measurements were quieter and less loud compared with the open unit, except when high-frequency ventilation (HFV) was used. Conclusion:The SFR level 3 NICU is a quieter, less loud environment compared with the open unit level 3 Bedside NICU when the patient is supported on room air, high flow nasal cannula, bubble continuous positive airway pressure and conventional ventilation. High HFV will result in similar measurements to the open unit level 3 bedside NICU.

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“…9 As a direct result of these factors, the traditional open-bay NICU (OPBY) environment may have contributed greatly to increased stress, 10 poorer perceptions of satisfaction with the nursery environment and poorer perceptions of the quality of the care provided among NICU staff. 11,12 An architectural solution proposed for many of these problems is the single-family room (SFR) NICU design. 13,14 When used in conjunction with appropriate methods to control the environmental factors that impact the tiny neonate together with the institution of family centered 8 and developmental care, 15,16 the SFR NICU is hypothetically superior to the conventional OPBY facility both from the standpoint of improved physiologic stability and better long-term infant development.…”

Section: Introductionmentioning

confidence: 99%

Neonatal intensive care nursery staff perceive enhanced workplace quality with the single-family room design

et al. 2009

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Objective: To compare perceived workplace quality in an open-bay neonatal intensive care unit (NICU) and a single-family room (SFR) NICU.Study Design: Prospective non-randomized, non-controlled cohort study.Result: Staff workplace quality perceptions assessed included the following: the quality of being a Sanford Health System employee (NSFnot significant), the quality of the NICU physical work environment, the quality of NICU patient care, the job quality in the NICU, the quality of health and safety in the NICU (NS), the quality of safety and security in the NICU, the quality of interaction with other members of the NICU health-care team (NS; in subanalysis nurse scores significantly declined), the quality of interaction with NICU technology and the off-job quality of life (NS). Scores for each category and the total scores were statistically greater in the SFR, except as noted (NS). Conclusion:Staff perceptions of workplace quality were significantly greater in the SFR than the open-bay NICU.

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The impact of single family room design on patients and caregivers: executive summary

Cited by 81 publications

References 33 publications

From bedlam to bedroom: almost there?

From bedlam to bedroom: almost there?

Comparing sound measurements in the single-family room with open-unit design neonatal intensive care unit: the impact of equipment noise

Neonatal intensive care nursery staff perceive enhanced workplace quality with the single-family room design

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