PHYSICAL LAYOUT

In this section we shall focus on location floor plan, ventilation, lighting environmental temperature and humidity, acoustic characteristic, communication system.

Space and Location
Each neonate should be provided with a minimum area of 100 square feet. Neonatal care unit should be located as close as possible to the labour room and obsteric operation theatre to facilitate prompt transfer of sick and high risk neonate.

Floor Plan
The neonatal care unit should be preferably in a square space so that abandoned open unencumbered space is available. The wall should be made of glazed tile and windows should have two layers of glass panes to ensure heat and sound insulations. Wash basins with elbow or foot operated tap having round the clock water supply should be provided. The door should be provided with automatic
door closures. Built in wall wooden cabinet with foldable cover should be used for stocking purposes. There should be isolation room where effected neonate with neonatal sepsis should be nursed. There should be breast feeding room for promoting practice of exclusive breast feeding and educating mothers.

Ventilation and Lighting
Effective air ventilation of nursery is essential to reduce nosocomial infection. The most satisfactory ventilation is achieved by laminated air flow system. Simple methods to achieve satisfactory ventilation consist of provision of exhaust fan in a reversed direction near the ceiling for input of fresh uncontaminated air and fixation of another exhaust fan in the conventional manner near the floor air exit. Constant positive air pressure should be maintained in the nursery so that contaminated air from the corridor does not gain access into the nursery. The nursery must be well illuminated and painted with white or slight *off-white to permit prompt and early detection of jaundice and cyanosis. It is best achieved by cool white fluorescent tubes to provide at least 100 foot candle, shadow free illumination at the infant level.

Environment Temperature and Humidity
The temperature of the nursery complex must be maintained around 28 +_- 2 degree centigrade indoor to minimize effects of thermal stress on the babies. This is best achieved by centralized air conditioning having temperature control knobs in the nursery. Portable radiant heater, -infrared lamp or bulb can be used to provide additional source of heat to an individual infant. Humidity is maintained
around 50 per cent Neonatal care unit should be equipped with room thermometer and hygrometer.

Acoustic Characteristic and Communication System
Sound intensity in the nursery should not exceed 75 db to protect hearing of nursery personnel and infants. Telephone rings and equipment's alarms should be replaced by blinking light. Decibel meter should be installed to monitor sound level in the nursery. The beneficial and soothing effect of meaningful sound such as gentle music or recording of parent.voice should be harnessed to provide
physiologic stability to the babies.
The nursery complex should be provided with an intercom system so that additional person can be called for help in case of emergency. A direct line external telephone in mandatory so that parents have an easy access to enquire about welfare of their infants. Mobile phone should not be used near the vicinity of nursery because the electromagnetic waves are liable to interfere with the functioning of the electronic equipment.