NICU Standard 6: Minimum Space, Clearance, and Privacy Requirements for the Infant Space
Multi-bed Infant Rooms
Each infant space shall contain a minimum of 150 square feet (14 square meters) of clear floor space, excluding handwashing stations, columns, and aisles (see Glossary). Within this space, there shall be sufficient furnishing to allow a parent to stay seated, reclining, or fully recumbent at the bedside. There shall be an aisle adjacent to each infant space with a minimum width of 4 feet (1.2 meters) in multiple bedrooms. When single infant rooms or fixed cubicle partitions are utilized in the design, there shall be an adjacent aisle of not less than 8 feet (2.4 meters) in clear and unobstructed width to permit passage of equipment and personnel.
Multiple bedrooms shall have a minimum of 8 feet (2.4 meters) between infant beds. There shall be provision for visual privacy for each bed, and the design shall support speech privacy at a distance of 12 feet (3.6 meters).
Private (Single-Family) Rooms
Rooms intended for the use of a single infant and his/her family shall conform to the requirements for infant spaces designated elsewhere in these standards, with the following exceptions:
• Minimum size shall be no less than 180 square feet (16.7 square meters) of clear floor area.
● An outside window is not required (see Standard 26 for further specifics).
● The requirement for wireless monitors and communication devices shall be identical to that described for isolation rooms (Standard 8).
● Each room shall be designed to allow visual and speech privacy for the infant and family, including skin-to-skin care, breastfeeding, and pumping.
Family space shall be designated and include, at a minimum:
● comfortable reclining chair suitable for kangaroo/skin-to-skin care
● A recumbent sleep surface for at least one parent
● A desk or surface suitable for writing and/or use of a laptop computer
● At least four electrical outlets for use and charging of electronic devices.
● No less than 6 cubic feet (0.2 cubic meter) of storage space
● Staff space shall be designated and include, at a minimum:
● A work surface of no less than 6 square feet (0.6 square meters)
● A charting surface of no less than 3 square feet (0.3 square meters)
● Supply storage of no less than 30 cubic feet (0.85 cubic meter).
§ NOTE: The above requirements can be met by any combination of fixed and portable casework desired, but all storage must be designed for quiet operation.
Specialized Infant Care Space or Rooms
Infant care space designed to accommodate specialized bedside procedures that require additional space for equipment, staff and other needs (e.g., extracorporeal membrane oxygenation, or ECMO, space-intensive bedside surgical procedures that require higher minimum space standards for staff and equipment) shall have a minimum clear floor area of 225 square feet (21 square meters) per infant in multi-bed rooms and 300 square feet (27.9 square meters) in single-bed rooms.
Interpretation: These numbers are minimums and often need to be increased to reflect the complexity of care rendered, bedside space needed for parenting and family involvement in care, and privacy for families.
The width of aisles in multiple bedrooms should allow for easy movement of all equipment that might be brought to the infant's bedside, as well as easy access to a maternal bed. The width of the corridors or aisles outside single infant rooms or infant spaces designed with permanent cubicle partitions should allow for simultaneous passage of two such items as mandated by state and federal architectural and fire codes.
The need for visual and acoustic privacy for infants and families should be addressed not only in design of each bed space, but also in the overall unit design - for example, by minimizing traffic flow past each bed.
Private (single-family) rooms allow improved ability to provide individualized and private environments for each baby and family when compared to multi-patient rooms. In order to provide adequate space at the bedside for both caregivers and families, however, these rooms need to be somewhat larger than an infant space in an open multi-bed room design, and they must have additional bedside storage and communication capabilities in order to avoid isolation or excessive walking of caregivers. A sleep surface for a second parent, bathroom, shower, and lockable storage for parents should be provided whenever possible.
While sleep space for two parents is recommended, if that sleep space is part of the infant’s room, parents may not always experience good quality sleep due to noise and staff activity. Since parents are already at risk of mental health issues related to their infant’s hospitalization, protecting the quality of their sleep is important. Consider separating the infant space from the parent sleep space if possible, and/or providing additional hoteling space elsewhere on campus for parents. The goal of providing sleep space for parents is to remove barriers to their participation and to facilitate attachment, but that should not be done at the expense of their wellbeing. Parents should feel invited but not compelled to stay.
Although desirable, it may not be possible to provide a window for each room due to a finite amount of outside wall area. It is most important to utilize the available window area first for the gathering spaces used by family and caregivers, and then secondarily for patient rooms.