Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

NICU Nurses' Stress and Work Environment in an Open Ward Compared to a Combined Pod and Single-Family Room Design

Feeley, Nancy PhD, RN; Robins, Stephanie MSc; Charbonneau, Lyne MN, RN; Genest, Christine PhD, RN; Lavigne, Geneviève PhD; Lavoie-Tremblay, Mélanie PhD, RN

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PhD, RNC-NIC;

doi: 10.1097/ANC.0000000000000603
Original Research

Background: The architectural design of a neonatal intensive care unit may affect the quality of the work environment for nurses, yet few studies have been conducted using reliable and valid measures. Recent studies have suggested some drawbacks of single-family rooms (SFRs) for both infants and parents. Research is needed to explore nurses' work environment in units combining pods and SFRs.

Purpose: To compare neonatal intensive care unit nurses' work stress, satisfaction, obstacles, support, team effectiveness, ability to provide family-centered care, and satisfaction with noise, light, and sightlines in an open ward with a new unit of pods and SFRs.

Methods: A pre-post occupancy study was conducted in a level 3 unit before and after transitioning to a new unit of 6-bed pods and SFRs.

Results: There were no significant differences in nurse stress, satisfaction, support from colleagues, perceptions of team effectiveness, and ability to provide family-centered care between the open ward and the pod/SFR unit. Organizational obstacles, such as difficulties obtaining information from colleagues, were significantly lower in the pod/SFR. In contrast, environmental and technology obstacles were greater in the new pod/SFR unit.

Implications for Practice: Some specific aspects of the pod/SFR unit are optimal for neonatal intensive care unit nurses, while other aspects of the open ward are perceived more favorably.

Implications for Research: Studies are needed to examine the isolation the nurses may experience in SFR units, as well as strategies to reduce isolation.

Ingram School of Nursing, McGill University, Centre for Nursing Research, Jewish General Hospital, Montreal, Quebec, Canada (Dr Feeley); Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada (Ms Robins); Neonatology, Jewish General Hospital, Montreal, Quebec, Canada (Ms Charbonneau); Faculty of Nursing, University of Montreal, Montreal, Quebec, Canada (Dr Genest); and Ingram School of Nursing, McGill University, Montreal, Quebec, Canada (Drs Lavigne and Lavoie-Tremblay).

Correspondence: Nancy Feeley PhD, RN, Ingram School of Nursing, McGill University, Centre for Nursing Research, Jewish General Hospital, 3755 Côte-Sainte-Catherine Rd, H-301.1, H3T 1E2, Montreal, Quebec, Canada (

This study was funded in part by Réseau de recherche en interventions en sciences infirmières du Québec (RRISIQ)/The Quebec Network on Nursing Intervention Research.

Nancy Feeley is supported by a Senior Research Scholar Award from the Fonds de recherche du Québec—Santé (FRQS).

The authors declare that they have no conflicts of interest to report.

© 2019 by The National Association of Neonatal Nurses