Hospital Architecture Evaluation: Neonatal Unit
DOI:
https://doi.org/10.3989/ic.73940Keywords:
neonatal unit, neonatal intensive care unit, post-occupancy evaluation, design evaluation, evaluation tool, evaluation instrument, evidence-based design processAbstract
The pursuit of efficiency and quality is particularly relevant in healthcare architecture because its design has a direct impact on clinical outcomes. Within a hospital, the neonatal unit is the place where patients are most vulnerable to their surrounding environment. This study evaluates the design of two Spanish neonatal units using architectural layout analysis, photo analysis and the post-occupancy-evaluation tool CURARQ-UNeo, and compares these against national guidelines and principles based on the evidence-based design process. The results from these studies are used to identify areas for improvement in each unit. This kind of evaluation might enhance the progress of the evidence-based design process in Spain, with the aim of guiding project decisions that contribute towards improving the quality of life of neonates, their relatives and the staff in the neonatal unit.
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(1) Alvarez-Ude, L. (2003). Edificación y desarrollo sotenible. GBC: un método para la evaluación ambiental de edificios. Informes de la Construcción, 55(486): 63-70. https://doi.org/10.3989/ic.2003.v55.i486.556
(2) Garcia-Erviti, F., Armengot-Paradinas, J., Ramírez-Pacheco, G. (2015). El análisis del coste del ciclo de vida como herramienta para la evaluación económica de la edificación sostenible. Estado de la cuestión. Informes de la Construcción, 67(537): e056. https://doi.org/10.3989/ic.12.119
(3) Macías, M., García-Navarro, J. (2010). Metodología y herramienta VERDE para la evaluación de la sostenibilidad en edificios. Informes de la Construcción, 62(517): 87-100. https://doi.org/10.3989/ic.08.056
(4) Valderrama-Ulloa, C., Puiggali, J.R. (2014). Requerimientos de usuarios de la edificación traducidos en una metodología de apoyo a la decisión. Informes de la Construcción, 66(534): e022. https://doi.org/10.3989/ic.12.106
(5) Vischer, J.C. (2008). Towards a user-centred theory of the built environment. Building Research & Information, 36(3): 231-240. https://doi.org/10.1080/09613210801936472
(6) Thomson, D.S., Austin, S.A., Devine-Wright, H., Mills G.R. (2003). Managing value and quality in design. Building Research & Information, 31(5): 334-345. https://doi.org/10.1080/0961321032000087981
(7) Leaman, A., Stevenson, F., Bordass, B. (2010). Building evaluation: practice and principles. Building Research & Information, 38(5): 564-577. https://doi.org/10.1080/09613218.2010.495217
(8) Dewulf, G., Van-Meel, J. (2004). Sense and nonsense of measuring design quality. Building Research & Information, 32(3): 247-250. https://doi.org/10.1080/0961321042000189662
(9) Zimmerman, A., Martin, M. (2001). Post-occupancy evaluation: benefits and barriers. Building Research & Information, 29(2): 168-174. https://doi.org/10.1080/09613210010016857
(10) Gann, D., Salter, A., Whyte, J. (2003). Design Quality Indicator as a tool for thinking. Building Research & Information, 31(5): 318-333. https://doi.org/10.1080/0961321032000107564
(11) Bordass, B. (2003). Learning more from our buildings - or just forgetting less? Building Research & Information, 31(5): 406-411. https://doi.org/10.1080/0961321031000108825
(12) Guyatt, G., Cairns, J., Churchill, D., Cook, D., Haynes, B., Hirsh, J. et al. (1992). Evidence-Based Medicine: A New Approach to Teaching the Practice of Medicine. JAMA, 268(17): 2420-2425. https://doi.org/10.1001/jama.1992.03490170092032 PMid:1404801
(13) Center for Health Design. (2015). An Introduction to Evidence-Based Design: Exploring Healthcare and Design. EDAC Study Guide Series, 3rd ed. Vol.1, p. 1-2, Concord (CA): The Center for Health Design.
(14) Center for Health Design. (2018). Building the Evidence Base: Understanding Research in Healthcare Design. EDAC Study Guide Series, 4th ed. Vol. 2, p.1, Concord, CA: The Center for Health Design.
(15) Ulrich, R.S. (1984). View through a window may influence recovery from surgery. Science, 224(4647): 420-421. https://doi.org/10.1126/science.6143402 PMid:6143402
(16) Ulrich, R.S., Zimring, C., Zhu, X., et al. (2008). A Review of the Research Literature on Evidence-Based Healthcare Design. HERD: Health Environments Research & Design Journal, 1(3): 61-125. https://doi.org/10.1177/193758670800100306 PMid:21161908
(17) Paniagua-Caparrós, J.L., Isasi, J., Pieltain, A. (2000) Hospitales: la Arquitectura del Insalud 1986 - 2000. Vol. 1, p. 7, Madrid: Insalud.
(18) Araujo, R. (2010). Diseño y construcción del Hospital Infanta Leonor en Vallecas (Madrid). Informes de la Construcción, 62(520): 5-14. https://doi.org/10.3989/ic.10.030
(19) Santos-Guerras, J.J. (2003). Verticalidad versus horizontalidad. Historia de la construcción de hospitales en el siglo XX. Informes de la Construcción, 55(485): 13-25. https://doi.org/10.3989/ic.2003.v55.i485.559
(20) Altimier, L., Phillips, R.M. (2013). The Neonatal Integrative Developmental Care Model: Seven Neuroprotective Core Measures for Family-Centered Developmental Care. Newborn and Infant Nursing Reviews, 13(1): 9-22. https://doi.org/10.1053/j.nainr.2012.12.002
(21) Women and Newborn Health Service King Edward Memorial Hospital NCCU Clinical Guidelines. (2006). Environmental noise, light and noxious stimuli reduction. Family and Developmental Care. Perth.
(22) Hermida-Rodríguez, B. (2016). Arquitectura al servicio del Hospital Materno Infantil Gregorio Marañón. Revista española de pediatría: clínica e investigación, 72(5): 250-254.
(23) Westrup, B., Sizun, J., Lagercrantz, H. (2007). Family-centered developmental supportive care: a holistic and humane approach to reduce stress and pain in neonates. Journal of Perinatology, 27: S12-S18. https://doi.org/10.1038/sj.jp.7211724
(24) García-Río, M., Sánchez-Luna, M., Doménech-Martínez, E., et al. (2007). Revisión de los estándares y recomendaciones para el diseño de una unidad de neonatología. Anales de Pediatría, 67(6): 594-602. https://doi.org/10.1016/S1695-4033(07)70810-X
(25) Ministerio de Sanidad y Política Social. (2010). Cuidados desde el nacimiento. Recomendaciones basadas en pruebas y buenas prácticas. Madrid. http://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/atencionParto.htm
(26) Shepley, M.M. (2004). Evidence-based design for infants and staff in the neonatal intensive care unit. Clinics in Perinatology, 31(2): 299-311. https://doi.org/10.1016/j.clp.2004.04.005 PMid:15289034
(27) Ministerio de Sanidad, Servicios Sociales e Igualdad. (2014). Unidades de neonatología. Estándares y recomendaciones de calidad. Informes, estudios e investigación. Madrid. https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/EEyRR_org.htm
(28) Stevens, D.C., Khan, M.A., Munson, D.P., Reid, E.J., Helseth, C.C., Buggy, J. (2007). The impact of architectural design upon the environmental sound and light exposure of neonates who require intensive care: an evaluation of the Boekelheide Neonatal Intensive Care Nursery. Journal of Perinatology, 27: S20-S28,. https://doi.org/10.1038/sj.jp.7211838 PMid:18034175
(29) Aita, M., Stremler, R., Feeley, N., et al. (2019) Acceptability to nurses of reducing NICU light and noise levels during skin-to-skin care: A pilot study. Applied Nursing Research, 47: 29-31. https://doi.org/10.1016/j.apnr.2019.03.001 PMid:31113542
(30) Fortes-Garrido, J.C., Velez-Pereira, A.M., Gázquez, M., Hidalgo-Hidalgo, M., Pedro-Bolívar, J. (2014). The characterization of noise levels in a neonatal intensive care unit and the implications for noise management. Journal of Environmental Health Science & Engineering, 12(104). https://doi.org/10.1186/2052-336X-12-104
(31) Szczepanski, M., Kamianowska, M. (2008). The ilumination intensity in the neonatal intensive care unit. Archives of Perinatal Medicine, 14(2): 47-50.
(32) Lasky, R.E., Williams, A.L. (2009). Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit. Pediatrics, 123(2): 540-546. https://doi.org/10.1542/peds.2007-3418 PMid:19171620
(33) Philbin, M.K., Evans, J.B. (2006) Standards for the acoustic environment of the newborn ICU. Journal of Perinatology, 26: S27-S30. https://doi.org/10.1038/sj.jp.7211585
(34) Disher, T., Dol, J., Richardson, B., Campbell-Yeo, M. (2017). Single room versus open-bay design in neonatal intensive care units for improvement in infant outcomes: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 15(10): 2480-2486. https://doi.org/10.11124/JBISRIR-2017-003346 PMid:29035959
(35) Joshi, R., Van-Straaten, H., Van-de-Mortel, H., et al. (2018). Does the architectural layout of a NICU affect alarm pressure? A comparative clinical audit of a single-family room and an open bay area NICU using a retrospective study design. BMJ Open, 8(6): e022813. https://doi.org/10.1136/bmjopen-2018-022813 PMid:29961040 PMCid:PMC6045752
(36) Toivonen, M., Lehtonen, L., Loyttyniemi, E., Axelin, A. (2017). Effects of single-family rooms on nurse-parent and nurse- infant interaction in neonatal intensive care unit. Early Human Development, 106-107: 59-62. https://doi.org/10.1016/j.earlhumdev.2017.01.012 PMid:28199954
(37) Vohr, B.R. (2019). The importance of parent presence and involvement in the single-family room and open-bay NICU. Acta paediatrica, 108(6): 986-988. https://doi.org/10.1111/apa.14783 PMid:30957269
(38) Sadatsafavi, H., Niknejad, B., Shepley, M., Sadatsafavi, M. (2019). Probabilistic Return-on-Investment Analysis of Single- Family Versus Open-Bay Rooms in Neonatal Intensive Care Units-Synthesis and Evaluation of Early Evidence on Nosocomial Infections, Length of Stay, and Direct Cost of Care. Journal of Intensive Care Medicine, 34(2): 115-125. https://doi.org/10.1177/0885066616689774 PMid:28118769
(39) Winner-Stoltz, R., Lengerich, A., Hench, A.J., O'Malley, J., Kjelland, K., Teal, M. (2018). Staff Nurse Perceptions of Open-Pod and Single Family Room NICU Designs on Work Environment and Patient Care. Advances in Neonatal Care, 18(3): 189-198. https://doi.org/10.1097/ANC.0000000000000493 PMid:29794838
(40) Denham, M.E., Bushehri, Y., Lim, L. (2018). Through the Eyes of the User: Evaluating Neonatal Intensive Care Unit Design. HERD: Health Environments Research & Design Journal, 11(3):49-65. https://doi.org/10.1177/1937586718761017 PMid:29504428
(41) Liu, L., Mozajarinia, M., Axelin, A., Feeley, N. (2019). Parents' Experiences of Support in NICU Single-Family Rooms. Neonatal Network, 38(2): 88-97. https://doi.org/10.1891/0730-0832.38.2.88 PMid:31470371
(42) Dunn, M.S., MacMillan-York, E., Robson, K. (2016). Single Family Rooms for the NICU: Pros, Cons and the Way Forward. Newborn and Infant Nursing Reviews, 16(4): 218-221. https://doi.org/10.1053/j.nainr.2016.09.011
(43) Jobe, A.H. (2017). The Single-Family Room Neonatal Intensive Care Unit-Critical for Improving Outcomes? Journal of Pediatrics, 185: 10-12. https://doi.org/10.1016/j.jpeds.2017.02.046 PMid:28284482
(44) Australasian Health Facility Guidelines. (2014). Health Facility Briefing and Planning. https://healthfacilityguidelines.com.au/hpu/intensive-care-neonatal-special-care-nursery-0
(45) Department of Health. (2013). Health Building note 09-03: Neonatal units, in 8720:0.6: England: Department of Health. https://www.gov.uk/government/publications/guidance-on-the-planning-and-design-of-neonatal-units
(46) Memoria 2017 Departament de Salut de València - Clínic - La Malva-Rosa. (2017). Generalitat Valenciana. Conselleria de Sanitat Universal i Salut Pública. http://clinicomalvarrosa.san.gva.es/memorias-departamento
(47) Memoria de gestión de la Conselleria de Sanitat Universal i Salut Pública. Año 2017. (2017). Generalitat Valenciana. http://www.san.gva.es/memoria-2017
(48) Hospital Clínic Universitari. (1994) Generalitat Valenciana. Conselleria de Sanitat i Consum.
(49) Zavala-Lafora, J., Flórez-Plaza, F., Picabea-Cervino, J. (1972). Ciudad Sanitaria de la Seguridad Social «La Fe» - Valencia (España). Informes de la Construcción, 25(240): 35-64. https://doi.org/10.3989/ic.1972.v25.i240.3235
(50) Cambra-Rufino L. (2018, 21 de septiembre). Designing a Post-Occupancy-Evaluation (POE) Tool for Hospitals. En 9th European Research in Architecture and Urbanism Congress EURAU18 (pp. 539-544). Alicante: Universidad de Alicante. Escuela Politécnica Superior
(51) Cambra-Rufino, L., Paniagua-Caparrós, J.L. Hospitalización neonatos 201906CURARQ-UNeo (2019). https://curarq.net/hospitalizacion-neonatos/
(52) Quan, X., Joseph, A., Nanda, U. (2017). Developing Evidence-based Tools for Designing and Evaluating Hospital Inpatient Rooms. Journal of Interior Design, 42(1):18-38. https://doi.org/10.1111/joid.12091
(53) https://curarq.net/unidad-de-neonatologia-hospital-clinico-universitario-de-valencia/
(54) https://curarq.net/unidad-de-neonatologia-hospital-universitari-i-politecnic-la-fe/
(55) ProCure22 (P22) Construction Procurement Framework https://procure22.nhs.uk/
(56) Sykehusbygg HF http://sykehusbygg.no/
(57) Fröst, P. (2004) Designdialoger i tidiga skeden (Tesis doctoral publicada). Gotemburgo: Chalmers Tekniska Högskola.
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Ministerio de Educación, Cultura y Deporte
Grant numbers FPU15/02660
