Objective: This paper summarizes the results of a comprehensive
comparison of open-bay (OPBY) and single-family-room (SFR) neonatal intensive
care unit (NICU) designs.
Background: The NICU expanded from 7000 ft2 in two large
rooms to 27,000 ft2 with 45 individual family spaces.
Results: Sound measurements indicated a significant reduction in the
unoccupied SFR to less than half of the levels in the OPBY NICU. However,
respiratory support equipment generated levels well above those of the ambient
environment. Illumination was significantly reduced in the SFR. Ambient
illumination in nursing work areas was less than recommended. In other
comparisons with the OPBY NICU the SFR NICU was shown to have: a shorter
interval until full enteric feedings were established; improved parent
satisfaction; improved staff perceptions of the environment and care; a decrease
in nurses State-Trait Anxiety scores; an increased need for total numbers of
staff and nursing staff per shift; increased walking per shift by nurses and
nurse practitioners; and improved sleep time in a very small sample of patients.
Analysis of the cost of construction showed comparable cost per ft2;
however, the cost per bed in the SFR NICU was much greater because of the
increased area of this facility. Highly notable findings of this investigation
included the same incidence of adverse outcomes of care and a reduction in the
adjusted direct cost of care in the SFR NICU.
Conclusion: These data overwhelmingly support the SFR NICU in
preference to the traditional OPBY facility. They substantiate that the SFR NICU
should be the new standard for NICU care.
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