Introduction
The creation of formal planning guidelines for newborn intensive care units (NICUs) first occurred when Toward Improving the Outcome of Pregnancy was published in 19761.
This landmark publication, written by a multidisciplinary committee and published by the March of Dimes, provided a rationale for planning and policy for regionalized perinatal care and details of roles and facility design. Since then, the American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists (ACOG) have published several editions of their comprehensive Guidelines for Perinatal Care2, and The American Institute of Architects has likewise published several editions of their Guidelines for Construction of Hospital and Healthcare Facilities3.
The purpose of this committee is to complement the above documents by providing healthcare professionals, architects, interior designers, state healthcare facility regulators, and others involved in the planning of NICUs with a comprehensive set of standards based on clinical experience and an evolving scientific database.
With the support of Ross Products Division / Abbott Laboratories, a multidisciplinary team of physicians, nurses, state health planning officials, consultants, and architects reached a consensus on the first edition of these recommendations in January 1992. The document was sent to all members of the American Academy of Pediatrics Section on Perinatal Pediatrics to solicit their comments, and we also sought input from participants at the 1993 Parent Care Conference and an open, multidisciplinary conference on newborn ICU design held in Orlando in 1993. Subsequent editions of these recommended standards were then developed by consensus committees in 1993, 1996, 1999, 2002, 2006, 2007, 2012, and 2019 under the auspices of the Gravens Conference.
Various portions of these recommended standards have been adopted by the American Institute of Architects/Facilities Guidelines Institute Guidelines3, the AAP/ACOG Guidelines2, and by standards documents in several other countries. In the future, we will continue to update these recommendations regularly, incorporating new research findings, experience, and suggestions. We hope this document will continue to provide the basis for a consistent set of standards that can be used by all states and endorsed by appropriate national organizations and that it will also continue to be useful in the international arena.
While many of these standards are minimums, the intent is to optimize design within the constraints of available resources and to facilitate excellent health care for the infant in a setting that supports the family's central role and the staff's needs. Decision makers may find these standards do not go far enough, and resources may be available to push further toward the ideal.
Authors:
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Leslie Altimier DNP, RNC, NE-BC Chief Editor Journal of Neonatal Nursing(JNN) Regional Director - Neonatal Services SSM Health - Cardinal Glennon Children's Hospital 1465 S Grand Blvd St. Louis, MO 63104 513-706-8813 LAltimier@gmail.com |
Sue Ann Barton AIA, LEED AP, EDAC Principal ZGF Architects LLP 1223 SW Washington Street Portland, Oregon 97205 503-803-1531 sueann.barton@zgf.com |
Jesse Bender, MD NICU Medical Director Mission Health System 509 Biltmore Ave Asheville NC 28801 Cell: (828) 778-0374 George.Bender@msj.org |
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Joy Browne, PhD Associate Professor, University of Colorado School of Medicine Department of Pediatrics at the Children's Hospital 1056 E19th Ave Denver, CO 80218 303-861-6546 |
Debra Harris, PhD Associate Professor Family & Consumer Sciences, Interior Design Robbins College of Health and Human Sciences Baylor University One Bear Place #97346 Waco, TX 76798 Office Location: Goebel 103.01 Office Tel: 254.710.7255 Debra_Harris@Baylor.edu |
Carol B. Jaeger, DNP, RN, NNP-BC Associate Professor of Clinical Practice The Ohio State University College of Nursing Columbus, OH 43210 Consultant Carol B Jaeger Consulting, LLC 3143 Cranston Drive Dublin, OH 43017 P: 614-581-3647 |
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Beverley H. Johnson, FAAN Institute for Patient- and Family-Centered Care 6917 Arlington Road, Suite 309 Bethesda, MD 20814 301-652-0281 |
Carole Kenner, PhD, RN, FAAN, FNAP, ANEF CEO Council of International Neonatal Nurses, Inc. (COINN) Carol Kuser Loser Dean and Professor The College of New Jersey School of Nursing, Health, & Exercise Science 206 Trenton Hall 2000 Pennington Road Ewing, NJ 08628 P: 609-771-2541 |
Kathleen J. S. Kolberg, PhD Associate Dean of Science Asst. Director of the Center for Health Sciences Advising 219 Jordan Hall of Science University of Notre Dame Notre Dame, IN 46556 574-631-4890 |
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Angela Loder, Ph.D., WELL AP WELL Faculty Vice President, Research International WELL Building Institute 220 Fifth Avenue, 8th Floor New York, NY 10001 Phone: 773-803-0164 angela.loder@wellcertified.com |
Gilbert L. Martin, MD Pediatrix Medical Group Director, NICU Citrus Valley Medical Center 1135 S. Sunset, Suite 406 West Covina, CA 91719 P: 626-813-3716 gimartin@pol.net |
Sabah Mohammed MS, B.Arch Healthcare Designer, Planning + Strategies, Perkins & Will 1315 Peachtree St NE Atlanta, GA 30309 P: 209-407-8942 Sabah.Mohammed@perkinswill.com |
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Teri Oelrich MBA, BSN, FNIHD Consulting Partner/Healthcare NBBJ 310 SW 4th Portland OR 97204 206-223-5113 TOelrich@nbbj.com |
Lynne Wilson Orr, BID, March, OAA, MRAIC, NCARB, ARIDO, IDC Principal, Parkin Architects Limited 1 Valleybrook Drive Toronto, ON M3B 2S7 Canada P: 416-467-8000 |
M. Kathleen Philbin, RN, PhD Independent Researcher 43 Foxwood Dr. Moorestown, NJ 08057 P: 856-912-3197 |
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Mardelle McCuskey Shepley, D.Arch., FAIA Professor Human Centered Design Cornell University 3250C MVR Hall Ithaca, NY 14850-4401 P: 607.255-3165 mshepley@cornell.edu |
Jonas Shultz MSc EDAC CRP Human Factors Specialist, Health Quality Council of Alberta Adjunct Lecturer, Cumming School of Medicine, University of Calgary 210, 811 – 14 Street NW Calgary, AB T2N 2A4 P: 403-355-4440 Jonas.Shultz@hqca.ca |
Judith A. Smith, MHA Principal, Smith Hager Bajo, Inc. 10947 E Cannon Dr Scottsdale, AZ 85259 703-932-7727 |
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Tammy S. Thompson, EdD, RA, RID, CPXP, EDAC Director of Experience Engagement, Education & Design; ECU Health Assistant Professor College of Engineering NC A&T State University 1601 East Market Street Greensboro, NC 27411 |
Robert D. White, MD Chair Director, Regional Newborn Program Beacon Children’s Hospital 615 N. Michigan Street South Bend, IN 46601 P: 574-647-7141 |
Mark Rea, Ph.D., and Jack Evans, PE, provided valuable technical assistance to the committee.