Neonatal Intensive Care Units Design: Implementation Strategies in South Africa

This study explored factors influencing the implementation of environmental design guidelines to facilitate neurodevelopmental supportive care in neonatal intensive care units in a South African public hospital and recommended implementation strategies. A qualitative design, explorative, descriptive and contextual in nature was used, utilizing the Model of Synactive Organization of Behavioral Development as a guiding framework. Data collection was conducted during four focus group interviews with 20 professional nurses working in a neonatal intensive care unit (NICU). Thematic analyses were done using Tesch's eight-step approach. Three themes emerged: current practices regarding the best practice guidelines, reasons for not implementing best practice guidelines and recommendations to implement best practice guidelines. Available best practice guidelines were not implemented due to shortages of staff, poor maintenance plans, financial constraints and lack of resources. These aspects need to be addressed for best practice guidelines to be implemented and sustained to enhance preterm infants' neurodevelopmental outcomes.