Winner-Stoltz Regina, Lengerich Alexander, Hench Anna Jeanine, OʼMalley Janet, Kjelland Kimberly, Teal Melissa
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).
Adv Neonatal Care. 2018 Jun;18(3):189-198. doi: 10.1097/ANC.0000000000000493.
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.
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.
Incorporating design features that decrease staff isolation and walking and ensuring both patient and staff safety and security are important considerations.
Further study is needed on unit design at a microlevel including headwall design and human milk mixing areas, as well as on workflow processes.
新生儿重症监护病房在历史上一直被建造成开放式病房或多床病房,但自20世纪90年代以来,趋势是朝着单人家庭病房(SFR)单元发展。已发现SFR设计有助于促进以家庭为中心的护理,并改善患者的治疗效果和安全性。然而,SFR设计的新生儿重症监护病房对工作人员的影响好坏参半。
本研究的目的是比较注册护士对开放式病房与SFR新生儿重症监护病房工作环境的看法,并比较注册护士对两种新生儿重症监护病房设计对他们为患者/家庭提供护理的影响的看法。
方法/搜索策略:进行了一项前瞻性队列研究。在搬迁前6个月以及搬迁后3、9和15个月完成问卷调查。进行了一系列单因素方差分析,以比较8个领域中每个组的情况。使用主题分析对开放式问题进行评估。
SFR设计在环境质量、主要工作空间的控制、隐私和干扰、支持个人工作的单元特征以及支持团队合作的单元特征方面具有优势;开放式病房设计在步行方面更可取。
纳入减少工作人员孤立和步行的设计特征,并确保患者和工作人员的安全是重要的考虑因素。
需要在微观层面进一步研究单元设计,包括床头墙设计和母乳混合区域,以及工作流程。