# The effects of the introduction of the single-family room in neonatal and paediatric intensive care on the outcomes of paediatric patients, families, staff, and organizations: a mixed method systematic review

## TL;DR

Single-family rooms in neonatal and pediatric intensive care improve patient outcomes and family involvement but require careful implementation to support staff and avoid sensory deprivation.

## Contribution

A mixed-method systematic review analyzing the effects of single-family rooms in NICUs and PICUs on patients, families, staff, and organizations.

## Key findings

- SFRs in NICUs improve neonatal neurodevelopment, parental participation, and staff satisfaction.
- Infants in SFRs show better sleep regulation, higher breastfeeding rates, and shorter hospital stays.
- SFRs may cause sensory deprivation risks and communication challenges for healthcare staff.

## Abstract

The introduction of single-family rooms (SFRs) in neonatal (NICUs) and paediatric intensive care units (PICUs) enhances family involvement and transforms healthcare professionals’ approach to patient care. This shift promotes family-centred care while requiring adjustments in staff workflows and communication. Given the significant implications of this structural change, this review examines the effects of SFRs on paediatric intensive care patient outcomes, families, healthcare staff, and healthcare organizations.

A systematic search was conducted in PubMed, CINAHL, PsycINFO, EMBASE, SCOPUS and Web of Science databases and grey literature. Studies published in English, Italian, and Spanish from 2009 to 2025 were included. The review adhered to the Johanna Briggs Institute methodology and PRISMA reporting guidelines to ensure rigor and transparency.

A total of 649 records were identified, with 30 studies meeting inclusion criteria. Findings suggest that SFRs in NICUs positively impact neonatal neurodevelopment, parental participation, and staff experiences. Infants in SFRs demonstrated improved neurobehavioral outcomes, better sleep regulation, higher exclusive breastfeeding rates, and shorter hospital stays. Increased parental presence strengthened parent-infant bonding, facilitated earlier milk expression, and reduced maternal stress. However, concerns were raised regarding potential sensory deprivation, which could affect long-term language and motor development. From the healthcare staff perspective, SFRs were associated with increased job satisfaction, improved family-centred care, and reduced noise-related stress. However, some nurses reported greater emotional strain, professional isolation, and communication challenges. Organizationally, SFRs improved workflow efficiency, enhanced infection control adherence, and reduced costs due to shorter hospital stays. Despite these benefits, only one study evaluating in PICUs setting was included, highlighting a significant gap in research.

SFR NICUs offer substantial benefits in family-centred care, neurodevelopment, and hospital efficiency. Successful implementation requires careful planning to support staff well-being, promote collaboration, and address potential sensory deprivation. Healthcare administrators should ensure adequate training and emotional support of staff, and environmental enrichment strategies. Future research should focus on optimizing NICU designs to balance developmental advantages, parental engagement, staff satisfaction, and operational sustainability while expanding studies on PICU settings.

This review is registered in PROSPERO (CRD42024501520).