Walsh William F, McCullough Kristin L, White Robert D
Vanderbilt University School of Medicine, Nashville, TN 37232-9550, USA.
Adv Neonatal Care. 2006 Oct;6(5):261-70. doi: 10.1016/j.adnc.2006.06.002.
Theoretically, single patient room newborn intensive care units are designed to optimize the developmental outcomes of critically ill infants by providing individual patient environments with decreased stimulation and noise. This article reports the perceptions of 127 neonatal intensive care nurses after the move into a single room neonatal intensive care unit (NICU). The observations of the nurses were obtained using a questionnaire to identify some of the benefits, risks, and specific patient safety concerns related to the single room NICU design. The results suggest that in this setting the single patient room concept was deemed superior for patient care and parent satisfaction when compared to the large open unit. However, the nurses emphasize that the success of single room care model primarily depends on providing sufficient staff coverage, given the decreased patient visibility and greater distances between patients. Larger units also present unique communication, staff education, and quality improvement challenges. To further evaluate the impact of single room designs we evaluated data on important clinical issues, specifically noise levels and catheter-related infections provide objective measures of important improvements. Noise levels decreased from an average of 63 to 56 decibels and catheter-associated bloodstream infections fell from 10.1 per 1000 device days to 3.3 per 1000 device days in the 9 months after the move to single patient rooms. This article provides pragmatic design suggestions that should be prospectively considered to minimize staff isolation and stress.
从理论上讲，单人病房新生儿重症监护病房旨在通过为每位患者提供刺激和噪音较少的个体环境，来优化危重症婴儿的发育结局。本文报告了127名新生儿重症监护护士在搬入单人病房新生儿重症监护病房（NICU）后的看法。通过问卷调查获取护士们的观察结果，以确定与单人病房NICU设计相关的一些益处、风险和特定的患者安全问题。结果表明，在这种情况下，与大型开放式病房相比，单人病房概念在患者护理和家长满意度方面被认为更具优势。然而，护士们强调，鉴于患者可见度降低以及患者之间距离更远，单人病房护理模式的成功主要取决于提供足够的人员配置。大型病房还带来了独特的沟通、员工培训和质量改进方面的挑战。为了进一步评估单人病房设计的影响，我们评估了重要临床问题的数据，特别是噪音水平和导管相关感染情况，以提供重要改进的客观指标。搬入单人病房后的9个月内，噪音水平从平均63分贝降至56分贝，导管相关血流感染率从每1000个装置日10.1例降至每1000个装置日3.3例。本文提供了实用的设计建议，应前瞻性地加以考虑，以尽量减少员工的孤立感和压力。
