Lullaby and Good Light - Baby Design
Every year, thousands of premature infants grow and survive thanks to the wonders of medical science made available in hospital neonatal intensive care units (NICU). Today, an infant born at only 28 weeks gestation has a fighting chance for survival; at 30 weeks, the chance is almost guaranteed.
Naturally, the remarkable advances in medicine must necessarily receive a large amount of the credit for saving these babies. However, there have been advances in other areas that deserve credit, as well. For example, the concept of "kangarooing," or parents touching and holding their babies, helps regulate babies' body temperatures and encourages them to nurse or take a bottle. And the NICU itself--its architecture, design and especially lighting--can be made to support the growth and maturation of premature infants.
At the University of Minnesota/Fairview Riverside Neonatal Intensive Care Center in Minneapolis, MN--a joint venture between the two that is part of a new addition to the Fairview Riverside Hospital--the lighting was manipulated to the babies' advantage. According to Gregory E. Lecker, lighting designer at Michaud Cooley Erickson Consulting Engineers in Minneapolis, lighting in the unit is easily controlled and altered in order to work with babies' natural rhythms.
the circadian rhythms of newborns," says Lecker. "Without variations in lighting levels, newborn babies have difficulty distinguishing between day and night. Therefore, each fixture in the unit is individually controlled, so the staff can control and evaluate the light levels for each infant."
Like the dimable light fixtures, natural light that enters the NICU through shaded windows helps babies regulate their daytime/nighttime clocks. Radiant heat panels along the window wall prohibit drafts from chilling the infants.
In addition, in a brightly lit NICU there is a higher incidence of retinal damage than in a unit with reduced light levels. Babies who are exposed to consistently high levels of light, typically provided by overhead fluorescent lamps, lose their defensive eye-blink reflex after several months in the unit. And, if babies are under intense light round-the-clock, they may lose the ability to track objects with their eyes, which often inhibits mother and infant bonding.
Of course, for medical procedures that must be performed, adequate lighting is required. Positioned above each isolette, a single fluorescent fixture that is separately switched and dimmable is used for examinations. Within each of these overhead two-by two-foot fluorescent fixtures, a paracube louver shields the light from adjacent infants. In fact, unless viewed from directly underneath, the fixture appears to be turned off. The fluorescent light fixture above each baby also has an ultraviolet filter to prevent retinal damage. Curtains between each infant provide added protection from bright task lighting.
Ambient light in the NICU is provided by reflecting light off of a custom ceiling recess and using extruded aluminum pendants and wall brackets. The ceiling recess mirrors the U-shape of the unit.
"We were limited on where we could place cove lighting because with the mechanical penthouse directly above, we couldn't increase the roof height," says Lecker. "And we needed to work around the curtain tracks, as well as the mechanical ductwork and the medical gas piping. We finally solved the problem by constructing a 4 1/2-inch pop-up that is two feet wide, from which we suspended tubular fluorescent light fixtures."
Although only 4 1/2 inches deep, the pop-up makes the ceiling appear higher because light spreads across the two-foot width. The fixture has separate controls for uplights and downlights, thereby allowing staff to regulate the brightness of the ambiant lighting.
Around the perimeter of the unit, undercabinet task light lets doctors and nurses chart information without turning on the fixtures over the isolettes and disturbing the babies. All of the lighting chosen for the unit provides accurate color rendition, or in other words, is most like daylight. In some instances, the wrong light, such as warm white light, may make babies appear jaundiced when, in fact, they are not.
Warm Design
While the lighting plays an integral part in helping the babies feel better, the architecture and design of the University of Minnesota/Fairview Riverside NICU helps parents and family feel better. According to Jay Sleiter, AIA, president of BWBR in St. Paul, MN, and principal-in-charge for this project, the decor comforts and reassures moms and dads.
"We knew that having a child in an NICU has to be incredibly stressful," says Sleiter. "So, we wanted to overcome the high-tech requirements of the unit with design elements that were soft and pleasing."
The entry to the NICU is noted with oversized children's building blocks that spell out UKids. The motif is repeated at the nurses' station and in the nursery where different colored blocks distinguish one isolette from another. Nursery colors of mauve, teal, pink and blue, as well as soft tactile accessories like quilts and needlepoint artwork, lessen the institutional feel.
Light wood finishes and curving surfaces also help soften the unit's image. At the nurses' station, a portion of the desk is lowered to create a less formal reception. While the nursery required a hard floor surface for maintenance and cleaning purposes, the entry is carpeted for a quieter and calmer approach.
The University of Minnesota/Fairview Riverside Neonatal Intensive Care Center is a level three nursery. As such, seriously ailing infants are flown in by medical helicopter from a wide region that includes all of Minnesota and parts of Iowa and North Dakota. The helipad is on top of the hospital's original 12-story building. A careful arrangement of details eases transferring infants from the top of one building to the fourth floor of the addition. All babies enter the unit through the main entry, thereby creating a gentler transition--more so for parents than babies--into the high-tech nursery.
The NICU connects to the Women's Center on the forth floor of the main hospital. The hospital's main elevators divide the NICU from the Women's Center.
This project received a Twin Cities Section Award from the Illuminating Engineering Society and has been entered in regional and national competitions.
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