Designing the NICU

March 21, 2014

NICU Private SuiteBefore my son’s early arrival, NICU was not a word that was a part of my vocabulary. And before attending the Healthcare Design Conference, I never realized how much thought, effort and planning goes into the design of a NICU suite. In a way, being a part of the design team reminded me of my NICU experience. I was once again exposed to new terminology, concepts and ways of thinking that I had never considered.  Meeting the minds that design and plan the spaces that our fragile babies start their lives in was a pleasure. Getting to share our stories with them, explain the emotional side of the NICU and how each piece of equipment affects the parent and child was a privilege. Seeing the latest in NICU design and having the opportunity to give feedback and influence how thousands of families might be impacted was thrilling!

As part of the conference, attendees and NICU families were invited to walk a Patient Experience Simulation Lab, which consisted of a fully-built private NICU suite where parents, designers and NICU professionals could have meaningful conversations about design innovations to foster family-centered care. Coming from an open bay NICU experience, I was immediately drawn to the idea of a private NICU suite. The ability to spend quality one-on-one time with my baby to sing, cry, grieve, sleep, shower, pump, eat and just stare without feeling that I was in the way would have been such a relief.

There were many innovations in this simulation lab that impressed me. These are a few of my favorites:

NICU SuiteSleep Too Sofa – The Sleep Too Sofa is unique in that the entire one piece back unit flips over and becomes the sleeping surface. It’s very comfortable and similar to a mattress. When in the couch position, the middle section is a hard surface that can serve as a seat, or when raised several levels become a work surface for a computer or eating. Under the Sleep Too Sofa are built-in charging stations for electronic devices.  It works great for parents who are able to work from “home” or stay connected to family, a useful spot for jotting down notes while the staff makes rounds and a comfortable place to sleep.  

NICU Suite

Kangaroo Station – At the head of the Sleep Too Sofa and within reach of the bedside chair, the simulated NICU Suite had a computer station that was set up on an articulating arm that was specifically for the parents. Although it was mounted on the wall, it could be pulled over and down to the couch or over to the chair. The family could access the internet, television, or other education videos the hospital provides. This feature is designed to encourage parents to spend time providing kangaroo care as much as possible.

NICU simulation

Movi Chair –Brand new to the marketplace, the Movi chair is a transport chair that has success written all over it. From the footrest that goes flat to the floor (no tripping!) to the lift assist, this amazing chair took our simulation “moms” right up to the isolette side and raised them to a point that they were able to not only see their “newborn” in the isolette, but even be close enough to reach in with both arms and hold them, all without leaving a sitting position. Perfect for a mom recovering from a c-section or just needing extra support while their little one is too fragile to come out of the isolette to be held.

kangaroo wrap

Kangaroo Wrap – A wonderful lightweight cotton wrap that when wrapped around both the parent and baby, forms a secure hold to help maintain a good position for kangaroo care. Perfect for breastfeeding and snuggling too! Really helps keep all the wires and tubes stay in place and allows mom or dad to focus on their precious snuggle time with baby.

NICU Suite (4 of 9)

Penguin Fridge – This amazing little refrigerator was silent and mounted under the cabinet in the room. Due to being a drawer style, there was virtually no cold air lost when opening the drawer to get your milk out! And no bending over which is great for recovering c-sections mommies!

Penguin Warmer – Also featured in the suite was a countertop warmer that heats bottles to the exact temperature at the simple push of a button.  Moms and nurses alike will love this!

Draeger Isolette – Love that this isolette has kangaroo care mode that allows for continued temperature monitoring while the baby is with mom or dad. The unit also goes down low enough that mom can access baby while sitting in a wheelchair.

NICU Suite (9 of 9)Nicview – This was perhaps my favorite innovation of all! It consisted of a webcam for parents with a passcode to give to family and friends that allows for viewing of the baby anytime, anywhere! The camera is mounted on a flexible pole and can be positioned over the isolette or pointed toward the chair if the baby is enjoying kangaroo care or feeding time. This is a fairly new technology that is being put into hospitals around the country and is receiving rave reviews from parents and families alike.  

NICU Suite (2 of 9)Lighting – No detail was overlooked, including the lighting. The design team took into consideration the natural light cycle an infant and family would be exposed to if they were at home. There were several lighting levels in the room including a nighttime amber light which is to help replicate the circadian rhythms our bodies rely on to maintain sleeping and feeding schedules.

Patient-friendly headwalls – The private suite simulator also took great care for even the smallest things For example, the simulator suite was designed so that the wall that faces the parent (typically full of wires, tubes, and monitors) is smooth and tube-free with fold down tables, a parent light and other parent-friendly features. It makes the suite look more like a living room rather than a hospital-setting.

Separate work areas – There were distinct areas of the NICU suite that were designed for the parent and separate work areas for the nurses.  The result of this design is that mom and dad didn’t have to relocate when the medical staff came in to do their work. The staff could comfortably work in the isolette, chart and do all the things they needed while the parents could still remain comfortably where they were and feel they had their own space. This definitely encouraged patient-centered care and interaction between the family and staff as the hands-on care occurred.  Having defined spaces and privacy allowed for more sharing of medical information between the staff and parents during rounds or anytime.

Focus on Quiet – Because preemies startle easily and have exceptionally delicate systems, special attention was paid to the sound levels in the room. From the silent refrigerator, drawers with silent slide shut, and rubber flooring (which is also good for the staff who spend much of their shift on their feet), the design team focused on noise reduction in new and creative ways.  Silencing the monitors when the nurses were stationed outside were also part of the discussion, which can help in reduction of PTSD symptoms for parents.  

NICU Suite (5 of 9)

The privacy flag – A unique disposable fabric flag on a flexible arm that works on the track system was designed to come over the head of the chair to provide the parent a bit of privacy without completely drawing the room curtain.

Breast pump in every room – The design team recommended having a breast pump in every room so mom could comfortably pump at the bedside which has been shown to dramatically increase breast milk production. This also greatly reduces the amount of time mom has to be away which reduces her anxiety. One of the hardest things for a mom to do is leave the bedside for fear of missing something–a chance at a diaper change, a little smile, an update from the doctor or just the opportunity to be with their little one.

NICU Suite (3 of 9)The Family Lounge – One of the concerns of the design team with the private suite was that the families would be isolated and not spend time together and support one another.  The team suggested that for every 4-6 private rooms, a family lounge be provided where parents could gather to visit, eat, rest and visit with family members or other staff.  Support groups could take place in the lounge or siblings could come up for a family dinner while mom or dad are still just a few steps away from the baby.

There was so much more the design team considered when putting the suite together. To design the rooms with same sidedness, where to put the disposable room divider curtain, ADA compliance, how wide to make the door, the best way to bring daylight into the room, splash zones when washing hands, the best surfaces for de-contamination purposes and the list goes on and on. Being involved in this conference as a NICU parent and social worker was an exciting opportunity to enter the world of design and learn how hospitals, architects and designers come to the seemingly infinite decisions that impact how the doctors, nurses and parents experience the NICU.  It was a great honor to be invited to attend and bring this conference to bring a NICU parent’s perspective and voice to the decisionmakers who create spaces where babies receive state-of-the-art care.

Images Courtesy: Healthcare Design Conference