NICU Spaces: 3 Critical Design Components
My sister-in-law is a neonatal intensive care unit (NICU) nurse, and whenever she talks about her job, her patients, and the families she serves every day, I’m always filled with the same combination of dread/awe that’s probably hard-wired once you become a parent. NICU spaces are so specialized, so unique in what they do. While the importance of involving the family in patient care is recognized across all healthcare disciplines, in the NICU, it’s practically a requirement.
Tammy Thompson, founder of the Institute for Patient-Centered Design, lived that dread and awe firsthand when her son was born preterm and spent his first week of life in a Level 2 NICU. It’s an experience that’s profoundly shaped Thompson’s life and her architecture career.
And so for its 2013 patient- and family-centered design competition, the institute chose to focus on the NICU environment. Today it announced its three winners: Hord Coplan Macht Inc. for MedStar Franklin Square Medical Center in Baltimore; McMillan Pazdan Smith Architecture for Bon Secours St. Francis Health System in Greenville, S.C.; and Stantec Architecture Ltd. for “Hospital for Sick Children” in Toronto.
Among the competition’s jurors was Dr. Bob White, chairman of the Consensus Committee on Recommended Standards for Newborn ICU Design. Here, he shares what he feels are three of the most critical components of designing NICU space—the criteria he kept in mind when judging the submissions:
- Location of the parent chair in relation to the infant. “There should be careful attention placed on the idea that a mother (or father) would be sitting next to the bedside doing skin-to-skin (kangaroo) care. If a baby is on a ventilator or other major support, kangaroo care must be done right next to the headwall … and in some designs, this would seriously limit nursing and respiratory access to equipment. My recommendation is to start the design process with a kangaroo chair and baby in the center, not an incubator or bassinette, then add those in to make sure everything works. Otherwise there are serious limitations to when and for how long kangaroo care can be provided.”
- Sufficient space for family and nursing alongside standard equipment. “Sometimes headwalls are shown without equipment in place, but that’s not real life. How does this all work with all the equipment needed for a very sick baby, while still providing work space for the staff, room for an X-ray or echo machine to be brought in, and facilitating keeping the family at the beside whenever possible? Imagine what that would look like for each baby. In several cases there was mention of using a mockup [to develop design solutions], which of course is a great idea; and that’s the picture we need, not the bare walls of an empty room.”
- Infection Control. Follow FGI Guidelines and Recommended Standards by designing sinks to “support proper handwashing up to the elbows without considerable splashing and dripping. Infection is the greatest cause of morbidity and mortality in the NICU, and handwashing is the best way to reduce that.”
The competition winners will be awarded first, second, and third place during the Patient-Centered Design Reception at the Healthcare Design Conference in November. A full-scale model of a NICU patient room, inspired by the highest scoring submissions, will be unveiled on-site opening night, and will serve as a simulation lab in which Thompson and her team will lead workshops throughout the conference. For more information, click here.