Traditional open bay neonatal intensive care units can be redesigned to better suit family centered care application

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Abstract

The current study investigated several Jordanian NICUs suitability for implementing Family Centered Care in light of its physical design. It involved direct observation of NICUs within seven Jordanian private and public hospitals in the presence of department heads. Structured interviews of 10 items were also conducted with nurses who agreed to participate in their workplace. The main outcome measures included in the interviews were unit design and regulations/policies. Descriptive statistics were employed taking into consideration comments of participants and observations by the researcher. This study asserted the role of the design in hindering the application of FCC in NICUs. More than two thirds of participants indicated unsuitability of their NICUs for FCC. However, with nurses' willingness to play their part in any proposed reformation, these units can become better equipped to apply FCC principles. Future NICUs require shifting from traditional open bay to a family centered closed unit model.

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Background

Family Centered Care (FCC) is regarded by the majority of experts as the ideal approach and an important element in pediatric units (The American Academy of Pediatrics, 2012). All definitions of FCC generally circle around the same ideal of placing the child and family in the centre of care. The Institute for Patient- and Family-Centered Care in Australia (2014) defined FCC as “… an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial

Methods

To address the purpose of the study a descriptive exploratory design was employed. Approval to conduct the study was solicited from Hashemite University Review Board and a single approval from each facility. The setting of this study was seven neonatal units in seven different hospitals (4 public and 3 private hospitals) in the three main cities of Jordan (Amman, Zarqa, and Irbid). All these units were designed traditionally as open bay and espoused different numbers of children. On average,

Neonatal units' design

NICUs were from 4 public and 3 private hospitals. With limited variations across sectors, the included units varied in its designs. Some units included a designated space for parents and families, some included a room for doctors, and others included an isolation room and a breastfeeding/milk extraction room. No unit included family support space adjacent to the NICU and in some cases spaces provided for lactation support and consultation were not originally thought of by the designers but

Discussion

In open bay units, families rarely are involved directly in the care of their children and rarely are allowed to attend rounds and procedures (Cleveland, 2008). Although could be a culture of practice, anecdotal evidence linked this to the inappropriate design of the units. While the extent to which the design of the unit affects the implementation of FCC is not well understood, it is of policy relevance (Groothuis and Merode, 2007). This study evaluated the design of seven neonatal units and

Conclusion

This study asserted the role of the design in hindering the application of FCC in NICUs. From an architectural view, the physical structure of these units currently requires massive modification hence huge fund. However, and with nurses willingness to play their part, simple internal modification with minor physical change might be possible with lower costs. A designated place for parents to use while visiting can be a positive addition to improve care, increase parents' satisfaction, and allow

Conflicts of interest

No conflict of interest to be declared.

Funding source

This study was self funded

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