Moving to single patient family rooms- help!

[Cfholmes]

I'm an RN working on a committee to plan for a move into a new level III NICU with single patient family rooms. We will be moving from a 14 bed bay style to a 14 room unit with a work station between every 2 rooms and 2 nurses stations. Since it is a small unit with limited staff, we are struggling with how to best utilize staff for patient care, deliveries, and charge responsibilities. Wondering how others who have made this move have handled staffing and communication between staff. Are you using phones or hands free devices when you need help? Nurses are worried about not seeing their other patients when in a room. Safety for our babies is, of course, our main concern. Any input is welcome. Thanks!!!

[marienm, RN, CCRN]

Some of our adult ICUs are laid out this way. (Sorry, I know nothing about NICU.) Our hospital uses Vocera hands-mostly-free devices, with which we can call a certain person or blast to our assigned unit (emergencies only). Our adult rooms have bedside monitors (cardiac/ oximetry/most specialized pressure monitoring/EtCO2). There are remote monitor screens at the nurse's stations, in the medroom, and a couple of locations around the unit. Each workstation between pairs of rooms has a computer, a phone with its own extension that also rings when anyone calls the main unit phone #, and a customizable bedside monitor where the user can decide which beds are visible on that monitor (usually configured to display 4 beds).

I would feel a lot less comfortable without the bedside monitors...at least they give me some confidence that if there's a critical alarm someone will notice. I do love the privacy that these rooms provide for patients and their families. I don't know what your NICU policies are, but I would imagine that Mom can pump right at the bedside if she wants, or Dad can strip down for some skin-to-skin time, or whatever. And one crying baby won't = all crying babies!

[NICUmiiki, DNP, NP]

We have over 80 beds in single family rooms. Some are twin rooms. We are assigned a buddy for lunches and breaks. The nurses sit in the cubbies between the rooms. If our babies aren't next to each other, well sit next to the more acute one. We usually keep the doors open unless the parents are in the room. If we need help, we just yell. People come running. There's also a staff assist button next to the code button that makes a lot of noise in the nurse's station.

We have Space Lab monitors. One of the first things we do is set each of our monitors to watch for alarms in our own and our buddy's other rooms. The monitors plug into the call bell system. Critical alarms (low HR/apnea) activate the call bell for everyone in that nurses station and supply room to hear. I usually can't see the monitor in the nurses station, but I can see the monitor in the baby's room.

The call bell is tied to the phone system (Responder). We all have phones and log into Responder at the beginning of the shift. When your alarm goes off, even if you are in the cafeteria, your phone rings. You are also called secondary for your buddy's alarms.

We all look for the alarm, and don't relax until some yells "Got it!"

[Cfholmes]

Thank you for your insight!

[Cfholmes]

Thank you for helpful reply!