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Impact of the Design of Neonatal Intensive Care Units on Neonates, Staff, and Families: A Systematic Literature Review

Shahheidari, Marzieh MSc; Homer, Caroline PhD, MScMed (ClinEpi)

The Journal of Perinatal & Neonatal Nursing: July/September 2012 - Volume 26 - Issue 3 - p 260–266
doi: 10.1097/JPN.0b013e318261ca1d
FEATURE ARTICLES: Continuing Education

ABSTRACT Newborn intensive care is for critically ill newborns requiring constant and continuous care and supervision. The survival rates of critically ill infants and hospitalization in neonatal intensive care units (NICUs) have improved over the past 2 decades because of technological advances in neonatology. The design of NICUs may also have implications for the health of babies, parents, and staff. It is important therefore to articulate the design features of NICU that are associated with improved outcomes. The aim of this study was to explore the main features of the NICU design and to determine the advantages and limitations of the designs in terms of outcomes for babies, parents, and staff, predominately nurses. A systematic review of English-language, peer-reviewed articles was conducted for a period of 10 years, up to January 2011. Four online library databases and a number of relevant professional Web sites were searched using key words. There were 2 main designs of NICUs: open bay and single-family room. The open-bay environment develops communication and interaction with medical staff and nurses and has the ability to monitor multiple infants simultaneously. The single-family rooms were deemed superior for patient care and parent satisfaction. Key factors associated with improved outcomes included increased privacy, increased parental involvement in patient care, assistance with infection control, noise control, improved sleep, decreased length of hospital stay, and reduced rehospitalization. The design of NICUs has implications for babies, parents, and staff. An understanding of the positive design features needs to be considered by health service planners, managers, and those who design such specialized units.

Centre for Midwifery, Child and Family Health (Dr Homer), Faculty of Nursing, Midwifery and Health (Ms Shahheidari and Dr Homer), University of Technology Sydney, Broadway, New South Wales, Australia.

Corresponding Author: Caroline Homer, PhD, MScMed (ClinEpi), Faculty of Nursing, Midwifery and Health, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia (

This project did not receive any funding.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Submitted for publication: August 21, 2011; accepted for publication: January 14, 2012.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.