Saturday, October 19, 2013

Private NICU Room Pros and Cons

Some Neonatal Intensive Care Units (NICUs) consist of private rooms. Others are configured as open wards. There are positives and negatives to both settings.

My preemie had a private room in the NICU. Below are the positives and negatives of a private room, from my perspective. 

Positives

Provides Parents Privacy for Visits and Overnight Stays

A private NICU room may help parents feel more at home and encourage around-the-clock stays. I enjoyed having a private NICU room because I could visit whenever and as often as I wanted -- without worrying about inconveniencing another family. It was nice to be able to have intimate kangaroo care sessions and private pumping sessions without another family close by. 

Although our baby had a private NICU room for her entire stay, most of my visits occurred between 9 a.m. and 9 p.m. I only spent the night in the NICU once or twice. The NICU offered recliners, but sleeping beds, blankets, and pillows were not always available. I found the recliner to be incredibly uncomfortable -- and the shower stall to be pretty scary. So, I went home most nights to eat dinner and catch-up on sleep.

May Reduce Parent Stress and Anxiety

I was on edge every time an alarm went off in our baby's room. Alarms were always going off to alert doctors and nurses of bradys, desats, and other problems and conditions. Having a private NICU room somewhat limited our ability to hear alarms for other NICU patients. I think this helped us manage some of our stress and anxiety. 

May Reduce Sensory Stimulation

In the NICU, we learned that our preemie is very sensitive to sights and sounds. She can easily be over-stimulated. Having a private NICU room limited her exposure to sensory stimulation, such as loud sounds and bright lights. This could be viewed positively or negatively, so I have listed this as a positive and a negative.

May Reduce Exposure to Potential Illnesses

At the beginning of our NICU stay, it appeared that personnel hygiene policies were not always being enforced. We noticed that not all visitors or hospital personnel washed or sanitized their hands upon entry to the NICU. We "policed" NICU visitors as much as we could.  If we didn't see hand-washing, we said something. 

Unfortunately, a Methicillin-resistant Staphylococcus aureus (MRSA) outbreak took place during our stay. At least eight babies were colonized or infected with a MRSA. This outbreak impacted us personally. It was incredibly disappointing given that patient colonization and infection may have been avoided -- if proper hygiene protocols had been in place and enforced. 

As a result of the outbreak, many necessary changes were made by management concerning visitor and hospital personnel hygiene. Colonized and infected babies were put in isolation. Doctors, nurses, and other hospital personnel could only visit these rooms wearing new gloves and new protective gowns. 

I tend to think that a private NICU room reduces exposure to visitors -- and ultimately reduces the amount of exposure to germs that could cause potential illnesses.

Negatives

May Limit Interaction with Other NICU Parents

A private NICU room may limit interaction with other NICU parents. In general, I only saw other parents walking down the NICU halls or eating lunch in the NICU Parent Lounge. It was hard to develop and maintain a relationship with these parents -- especially since conversations in the doorways of private rooms was discouraged. It would have been nice to have had more opportunities to develop relationships and obtain support from others going through similar situations

May Reduce Sensory Stimulation

Although reducing sensory stimulation may be a positive, some may view it as a negative from a developmental perspective. 

May Reduce Teamwork Among Hospital Personnel

A nurse was assigned to care for our baby during each shift. The nurse typically cared for two or three babies. Although doctors and nurses responded to true emergencies quickly, it was often difficult to find our assigned nurse to raise questions and concerns -- or to turn off the feeding machine when it was beeping. We often found other nurses who suggested that our assigned nurse needed to attend to our needs. Accordingly, there appeared to be a lack of teamwork. 

What was your NICU experience?  Was your baby in an open ward or a private room?  In your opinion, what are the pluses and minuses of each setting?



2 comments:

  1. Open ward vs. a private room for a preemie through an adult would have many similar concerns. I would go for the private room. That reduces exposure to communicable things other patients may have.

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  2. Thanks, Cindy Jensen. I appreciate your view on this issue and completely understand your preference for private rooms. Like you, I believe that private rooms may reduce expose to germs from other patients, as well as visitors.

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