(PDF) The impact of single family room design on patients and caregivers: Executive summary

Jacki Roig

except the provision of waiting and resting space for families outside the NICU, and corridors and signage for wayfinding. As these two environmental factors are identical for Hospital 2, we can assume that the data are inconsequential. According to staff, single rooms are superior to open bays in terms of […]

except the provision of waiting and resting space for families

outside the NICU, and corridors and signage for wayfinding.

As these two environmental factors are identical for Hospital 2,

we can assume that the data are inconsequential.

According to staff, single rooms are superior to open bays in

terms of providing privacy to families and infants. This is most

strongly articulated in Hospital 1, which is limited to SFRs.

However, while the SFR-only NICU is perceived as less stressful

than the SFR portion of the combined unit, very little difference

was found in response to the question ‘the environment supports

the family’s presence and participation.’ This suggests that

common factors that are not associated with the physical

environment may be contributing to stress levels.

Consistent with their high ratings of the physical environment,

members of the nursing staff in Hospital 1 report less stress and

more satisfaction with their job than their counterparts in Hospital

2. Within this context, the most problematic areas in all three

locations were workload, inadequate preparation, death and dying,

and conflicts with physicians, all factors that are typically

independent of the physical environment. These factors have been

demonstrated in other studies to be challenging for nursing staff.

The study confirmed that nurse job satisfaction may be higher

in the SFR configurations. This satisfaction is corroborated by other

data indicating lower stress levels and perceptions of a higher

quality experience for families.


The purpose of this study was to explore the implications of SFR

design of NICUs comparison to other current design configurations.

We used a review of the literature and the results of this study to

provide practitioners with recommendations for the design of

NICUs and to present researchers with an agenda for future, more

focused research studies.

Based on the results of this study, SFR NICU design provides

solutions for increasing parent privacy and presence, supporting

HIPAA compliance, minimizing the number of undesirable beds,

increasing staff satisfaction and reducing staff stress. Potential

limitations of the SFR design are reduced parent-to-parent social

contract and isolation of both parents and staff. In the projects

reviewed in this study, construction cost was not notably influenced

by design configuration.


This study was supported by a research grant from the Coalition for Health

Environments Research (CHER) and is available at www.cheresearch.org. Support

was also provided by the Regional Newborn Program at Memorial Hospital, South

Bend, IN. Preliminary data were presented at the High Risk Infant Conference,

Orlando, FL, 27 January 2006. We thank the participating hospitals, architecture

firms and construction companies. We especially thank the other members of the

research team: Stanley Graven, MD; Leslie Parker, ARNP; Beverly Johnson; Judy

Smith, MHA; Teri Oelrich, RN; and Kathleen Philbin, PhD for their contributions

to the completion of this project.

Statistical Reviewer: Xiaobo Quan, M ARCH, College of Architecture, Texas

A&M University.


1 Als H Lawhon G, Duffy F, McAnulty G, Gibes-Grossman R, Blickman J.

Individualized developmental care for the very low birth-weight preterm

infant medical and neurofunctional effects. J Am Med Assoc 1994; 272:


2 Ferber SG, Makhoul IR. The effect of skin-to-skin contact (kangaroo care)

shortly after birth on the neurobehavioral responses of the term newborn: a

randomized controlled trial. Pediatrics 2004; 113(4): 858865.

3 Mathur NS. A single-room NICU the next-generation evolution in the

design of neonatal intensive care units. Am Inst Archit Acad J 2004,

Retrieved November 12, 2004, from http://www.aia.org/AAh_a_Jrn/


4 Miles MS, Funk SG. Parental Stressor Scale: Neonatal Intensive Care Unit.

1998 [cited July 15, 2005]; Available from: http://nursing.unc.edu/crci/


5 Bialoskurski M, Cox C, Wiggins R. The relationship between maternal needs

and priorities in a neonatal intensive care environment. J Adv Nurs 2002;

37(1): 6269.

6 Cescutti-Butler L, Galvin K. Parents’ perceptions of staff competency in a

neonatal intensive care unit. J Clin Nurs 2003; 12: 752761.

7 Conner J, Nelson E. Neonatal intensive care: satisfaction measured from a

parent’s perspective. Pediatrics 1999; 103(1): 336349.

8 Kent W, Tan A, Clarke M, Bardell T. Excessive noise levels in the neonatal

ICU: potential effects on auditory system development. J Otolaryngol 2002;

31(6): 355360.

9 Chang Y, Lin C, Lin L. Noise and related events in a neonatal intensive care

unit. Acta Paediatr Taiwanica 2001; 42(4): 212217.

10 Gray L, Philbin M. Effects of the neonatal intensive care unit on auditory

attention and distraction. Clin Pediatr 2004; 31(2): 246260.

11 Philbin M. The influence of auditory experience on the behavior of preterm

newborns. J Perinatol 2000; 20(8 Part 2): S77S87.

12 Philbin M, Gray L. Changing levels of quiet in an intensive care nursery.

J Perinatol 2002; 22(6): 455460.

13 Philbin M, Klass P. Hearing and behavioral responses to sound in full-term

newborns. J Perinatol 2000; 20(8 Part 2): S68S76.

14 Berens R, Weigle C. Cost analysis of ceiling tile replacement for noise

abatement. J Perinatol 1996; 16(3): 199201.

15 Johnson A. Adapting the neonatal intensive care environment to decrease

noise. J Perinatal Neonatal Nurs 2003; 17(4): 280288.

16 Ulrich R, Zimring C. The Role of the Physical Environment in the Hospital

of the 21st Century: A Once-in-a-Lifetime Opportunity. The Center for

Health Design: San Francisco, CA, 2004, May.

17 Oren I, Haddad N, Finkelstein R, Rowe J. Invasive pulmonary aspergillosis in

neutropenic patitents during hospital construction: before and after

chemoprophylaxis and institution of HEPA filters. Am J Hemotol 2001;

66(4): 257262.

18 Dharan S, Pittet D. Environmental controls in operating theatres. J Hosp

Infect 2002; 51(2): 7984.

SFR NICU design implications

DD Harris et al


Journal of Perinatology

Source Article

Next Post

10 Best Free Online Virtual Room Programs and Tools

Check out our updated review on a fantastic room design software company here. This company not only designs your space, but allows you to purchase the furniture and decor from your design. We hope you like the products we recommend. Just so you are aware, Freshome may collect a share of […]