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Staff Nurse Perceptions of Open-Pod and Single Family Room NICU Designs on Work Environment and Patient Care

Winner-Stoltz, Regina, MSN, APRN, PPCNP-BC; Lengerich, Alexander, MS, EdS; Hench, Anna, Jeanine, BSN, RN; O'Malley, Janet, ADN, RN; Kjelland, Kimberly, MSN, APRN, PPCNP-BC; Teal, Melissa, BSN, RNC-NIC

Section Editor(s): Samra, Haifa A.

doi: 10.1097/ANC.0000000000000493
Professional Growth and Development

Background: Neonatal intensive care units have historically been constructed as open units or multiple-bed bays, but since the 1990s, the trend has been toward single family room (SFR) units. The SFR design has been found to promote family-centered care and to improve patient outcomes and safety. The impact of the SFR design NICU on staff, however, has been mixed.

Purpose: The purposes of this study were to compare staff nurse perceptions of their work environments in an open-pod versus an SFR NICU and to compare staff nurse perceptions of the impact of 2 NICU designs on the care they provide for patients/families.

Methods/Search Strategy: A prospective cohort study was conducted. Questionnaires were completed at 6 months premove and again at 3, 9, and 15 months postmove. A series of 1-way analyses of variance were conducted to compare each group in each of the 8 domains. Open-ended questions were evaluated using thematic analysis.

Findings/Results: The SFR design is favorable in relation to environmental quality and control of primary workspace, privacy and interruption, unit features supporting individual work, and unit features supporting teamwork; the open-pod design is preferable in relation to walking.

Implications for Practice: Incorporating design features that decrease staff isolation and walking and ensuring both patient and staff safety and security are important considerations.

Implications for Research: Further study is needed on unit design at a microlevel including headwall design and human milk mixing areas, as well as on workflow processes.

Educational Development Department, Baptist Health Lexington, Lexington, Kentucky (Ms Winner-Stoltz); Nursing Administration, Baptist Health Lexington, and College of Education, University of Kentucky, Lexington, Kentucky (Mr Lengerich); Neonatal Intensive Care Unit, Baptist Health Lexington, Lexington, Kentucky (Mss Hench and O'Malley); Women's and Children's, Baptist Health Lexington, Lexington, Kentucky (Ms Kjelland); and Neonatal Intensive Care Unit, Franciscan Alliance, Indianapolis, Indiana (Ms Teal).

Correspondence: Regina Winner-Stoltz, MSN, APRN, PPCNP-BC, Educational Development Department, Baptist Health Lexington, 1800 Nicholasville Rd, Ste 301, Lexington KY 40503 (

This study was conducted at Baptist Health Lexington.

The authors declare no conflicts of interest.

© 2018 by The National Association of Neonatal Nurses