A model of nursing care microsystems for a large neonatal intensive care unit.

Nationally the number and size of neonatal intensive care units (NICUs) continues to grow. Today, NICUs with >40 beds, often referred to as "megaunits," are not uncommon. Staff in large units find it challenging to maintain teamwork, communication, and continuity of nursing care for patients. Families find large units overwhelming. In large NICUs, nurse leaders struggle to achieve a balance between parent satisfaction with care provided and nursing job satisfaction. This article describes the development of a new model of nursing practice, a nursing team microsystem. This innovative model has the unique effect of creating smaller units within the larger one, using highly skilled nursing teams, that are geographically grouped to provide care for infants and their families. The model supports teamwork, communication, continuity of care, and has shown a positive impact on both family and nurses' job satisfaction.