NICU design

Overview

The design of the neonatal intensive care unit (NICU), which comprises the built environment of a neonatal unit, may influence both short- and long-term outcomes of neonatal care. Evidence-based design can support family-centred care, safe and optimal working conditions for healthcare professionals, and other relevant aspects of good clinical practice. (1) Therefore, planning for a NICU environment needs to integrate scientific evidence and is also an issue of practical and smart technical and design solutions.

The health benefits of continuous parent participation, interaction, and skin-to skin care are significantly improved if the environmental design allows privacy and protects from visual and auditory stress by respective design of family-rooms. (2,3) Facilitating parent-infant closeness and skin-to-skin care throughout the 24 hours by an optimal design of the neonatal unit represent an underestimated opportunity for improving outcomes for infants. (4) Further elements of NICU design imply spatial division of the necessary facilities and appropriate lighting levels within the NICU that optimise the ability of healthcare professionals to perform care while meeting the health needs of patients and their families. (2) Utilisation of materials preventing elevated noise levels and infection is necessary. (5)

There may be a conflict between patient/family preferences and the preferences of the healthcare professionals, building, and technical department or administration, which needs to be acknowledged already in the planning process. Therefore, NICU planners, hospital administration, NICU staff, and parent representatives should be involved in the planning and building process or the rebuilding process of NICUs.

The Topic Expert Group on NICU design develops standards reflecting several infrastructural and design issues which optimally support the provision of high-quality and family-centred care.

Örtenstrand A, Westrup B, Broström EB, Sarman I, Akerström S, Brune T, et al. The Stockholm Neonatal Family Centered Care Study: effects on length of stay and infant morbidity. Pediatrics. 2010 Feb;125(2):e278-285.
Raiskila S, Axelin A, Toome L, Caballero S, Tandberg BS, Montirosso R, et al. Parents’ presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr Oslo Nor 1992. 2017 Jun;106(6):878–88.
Lester BM, Salisbury AL, Hawes K, Dansereau LM, Bigsby R, Laptook A, et al. 18-Month Follow-Up of Infants Cared for in a Single-Family Room Neonatal Intensive Care Unit. J Pediatr. 2016 Oct;177:84–9.
Heinemann A-B, Hellström-Westas L, Hedberg Nyqvist K. Factors affecting parents’ presence with their extremely preterm infants in a neonatal intensive care room. Acta Paediatr Oslo Nor 1992. 2013 Jul;102(7):695–702.
Lasky RE, Williams AL. Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit. Pediatrics. 2009 Feb;123(2):540–6.