The impact of the clinical environment on family centred care in the neonatal unit: A qualitative investigation

It has been suggested that the clinical environment has a significant impact on the wellbeing and recovery of patients. Furthermore, the design, physical environment and use of resources within the neonatal unit (NNU) is crucial to family centred care (FCC) and the provision of a supportive infrastructure for patients, families, staff and carers. It has also been claimed that poorly designed NNU can hinder the best intentioned efforts of NNU staff. This paper reports the findings of a qualitative investigation using non-participant observation and follow up interviews with key informants aimed at understanding ways in which the clinical environment might influence and impact upon the behaviour and practice of those employed within the NNU. Results indicate that topics such as noise, lighting, heating, ventilation and particularly space in which to care for patients and families are significant issues. It is concluded that poor clinical environments may impede staff in achieving improvements in care quality, and that an ergonomic, supportive environment is required within the NNU in order to enable quality care and increase efficiency. Further investigation into resource managed NNU, guided by lean thinking and the productive ward literature may provide a means of enabling improved FCC.