Assessment of Neonatal Intensive Care Unit Single Private Room Versus Open Room Environment and the Impact on Maternal and Neonatal Outcomes
- Identify the evidence of NICU environmental factors on infant physiologic parameters and health outcomes.
- Discuss implications of the NICU environment on maternal stress.
- Identify trends in the development of the NICU care delivery environment and research evidence related to single private room care.
Since the late 1990’s, an increasing trend for implementation of single private room neonatal intensive care unit (NICU) design is supported in health care and architectural literature; however, minimal research exists demonstrating the positive, negative or neutral impact of this type of NICU environment on high risk neonatal outcomes and perceptions of maternal stress.
The physical environment of the NICU has been documented to impact the infant’s physiologic status and development. The preterm infant’s body systems continue to mature following birth in an environment overloaded with sensory stimuli that may affect the infant’s natural development. The NICU environment has been negatively associated with disruption in family interaction. The NICU environment has also been identified as a significant source of stress for parents and this environmental stress may be a major factor contributing to overall distress and the development of parenting behaviors.
The environment of the NICU was relatively unchanged from its initiation in the 1960’s until the late 1980’s. The private room NICU design concept was identified in the literature in the1990’s based on modeling after the adult and pediatric intensive care unit private room design and published recommendations for application of the private room design to the high risk neonatal population. While there has been an increasing trend for the implementation of this room design since the 1990’s, determination of the design’s impact on cost, care quality, satisfaction, or environmental control has not been documented.
Proposed change: Construction of 7 single private NICU rooms was completed presenting an opportunity for active comparison of maternal and infant outcomes hospitalized in this environment with those in the 32 bed open room NICU environment.
Implementation, outcomes and evaluation: Outcomes related to average weight gain, length of stay, ventilator days, incidence of intraventricular hemorrhage, incidence of parent visitation, and maternal stress from this hospital setting were compared for the two environments of care with differences identified.
Implications for nursing practice: Evaluation of the increasing trend for single private room NICU environment of care development using evidence of the impact of environment on infant and maternal outcomes is necessary to identify if the increased cost of construction for this care environment truly improves health outcomes for these populations. Nurses and nursing leaders with knowledge of infant and maternal outcomes related to the NICU environment are able to influence the design of new construction to promote optimal care delivery to the high risk neonate and family members.
Keywords: Single Private Room, Environment, NICU
