Two Contrasting NICU Environments

Zahr, Lina Kurdahi

doi:10.1097/00005721-199801000-00007

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…To date, a new physical layout is primarily put in place to harmonize with the approach of individualized developmental care (Dearing, 2004;Floyd, 2005;Zahr, 1998). In this care approach, an infant's signals are interpreted as developmental competencies to which responsive actions are taken concerning the environment, safeguarding the infant from external disturbances such as unnecessary light and sound (Als, 1992).…”

Section: Introductionmentioning

confidence: 99%

Room for family-centered care – a qualitative evaluation of a neonatal intensive care unit remodeling project

Beck

Weis

Greisen

et al. 2009

Journal of Neonatal Nursing

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Section: Introductionmentioning

confidence: 99%

Room for family-centered care – a qualitative evaluation of a neonatal intensive care unit remodeling project

Beck

Weis

Greisen

et al. 2009

Journal of Neonatal Nursing

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“…The admission of a newborn infant to a NICU is a stressful event for parents compounded by the overall NICU environment (bright lights, loud noises, the complexity of the equipment surrounding their infant, the sight of other small and sick infants and the number of health care professionals working with the infants). The noise in the NICU has been linked to behavioural and physiological changes in preterm infants (Zahr and Balian, 1995;Zahr, 1998). The ambient noise levels in the NICU today are reduced by taking steps such as ensuring alarms of the monitors are controlled at minimally audible level, no tapping on the incubator, and lowered volume of the noise of nurses during handover period.…”

mentioning

confidence: 99%

“…The bright light can be reduced by the provision of individual cot side lamps, shading the infant's eyes with goggles or using incubator covers. Excessive handling of the infants had previously been shown to be associated with adverse physiological effects such as increased oxygen consumption, heart rate and respiratory rate (Evans, 1991;Zahr, 1998). Therefore health care professionals working in the area can help to minimise environmental stress for these parents and their infant's neurobehavioural systems by modifying the physical characteristics of the NICU and altering the pattern of caregiving activities.…”

mentioning

confidence: 99%

Stress experiences of parents with premature infants in a special care nursery

Lau

Morse

2003

Stress and Health

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This project is a controlled prospective longitudinal study of stress experiences of parents with premature infants born from 30-35 weeks gestation being cared for in a tertiary special care nursery (SCN). Sixty mothers and 59 fathers of premature infants and 60 mothers and fathers of term infants were recruited into the study. A range of repeated selfreports and biochemical markers of stress (cortisol and tribulin) were carried out on 5 measuring times through approximately a total of 24 weeks for parents of premature infants and 17 weeks for parents of term infants.Parents of premature infants reported higher stress levels than parents of term infants within the first week of infant's birth but had lower biochemical markers of stress. The stressors perceived by these parents in a SCN were appearance and behaviour of the infants and the delayed in performing the parental role. Parents used both emotion-and problemfocused coping strategies to deal with the stressful events.A follow-up telephone interview of these parents a year after the birth of their premature infant found that most parents expressed the experience as positive. A few parents were concerned over the neurodevelopmental and cognitive outcomes of their infants. Implications for clinical practice were discussed.

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“…However, traditional ward-style NICU (tNICU) may involve environmental stress to the neonate and are potentially detrimental for infants lacking mature organ systems and the ability to adapt to abrupt changes. [1][2][3][4] Consequently, NICUs are being redesigned into more developmentally appropriate environments with single rooms, controlled light and noise, clustering medical care to promote rest, and a family-centered approach to infant care. Single-family room-style NICUs (developmentally appropriate NICU [dNICU]) aim to reduce infant stress, implement strategies to manage environmental challenges, and individualize the plan of care to meet the special needs of the preterm infant; however, the implemented strategies for the NICU vary from study to study.…”

Section: Introductionmentioning

confidence: 99%

“…Preterm infant outcomes in the single-family room style are typically improved in regard to neurodevelopment and growth compared to the open-bay open-ward (traditional) NICU. [2][3][4]8,9 However, the environment and interventions vary significantly between studies, so it is difficult to compare outcomes of one specific variation in design.…”

Section: Introductionmentioning

confidence: 99%

Traditional open-bay versus single-family room neonatal intensive care unit: a comparison of selected nutrition outcomes

Erickson¹,

Kattelmann²,

Remington³

et al. 2011

RRN

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Background:In contrast to the traditional open-bay-type design of the neonatal intensive care unit (tNICU), infants in developmentally appropriate NICU (dNICU) are housed in individual rooms with greater control of light and noise. Previous reports have documented positive influence of the dNICU in cardiorespiratory status, physiologic stability, and weight gain of the infants. The objective of this study was to explore selected nutrition outcomes of infants in the dNICU versus tNICU. Method: A prospective cohort study was conducted on infants with birth weight of 1500 g or less cared for in dNICU (n = 42) or tNICU (n = 31). Differences between days to reach full parenteral nutrition, full enteral nutrition, or full bottling were determined using analysis of covariance controlling for gestational age, birth weight, and clinical risk index for babies (CRIB) acuity score. Results: There were no differences between the two groups in days to reach full parenteral and bottle feeding. The infants in the dNICU took fewer days to reach full enteral nutrition (20.8 days, 95% confidence intervals [CI]: 17, 24.6 (dNICU) vs 23.3 days, 95% CI: 17.1, 29.6 (tNICU), P = 0.04) than those in the tNICU. Conclusions: Although the two groups of infants only differed in the days to reach full enteral feeding, it is important to remember that the lack of difference may be clinically significant. Clinically, the infants in the dNICU were younger (gestational age) and sicker (CRIB acuity score) than the infants in the tNICU. Consequently, the results of this study support the change to dNICU, as the private room model provides a supportive environment for growth as evidenced by similar nutritional outcome measures. More research is needed to determine the effect of the dNICU on nutrition outcomes.

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Two Contrasting NICU Environments

Cited by 4 publications

References 10 publications

Room for family-centered care – a qualitative evaluation of a neonatal intensive care unit remodeling project

Room for family-centered care – a qualitative evaluation of a neonatal intensive care unit remodeling project

Stress experiences of parents with premature infants in a special care nursery

Traditional open-bay versus single-family room neonatal intensive care unit: a comparison of selected nutrition outcomes

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