General changes:  The Standards have been re-numbered to allow similar topics to be positioned together in the document.

Standard 5:  This Standard now explicitly states that space must be provided at the bedside to allow for extended, intimate parental contact with the infant.

Standard 6:  The minimum clear floor space for single patient rooms has been increased to 165 square feet, based on extensive experience with NICUs that have incorporated this feature and found that rooms any smaller than this are universally considered to be too small.  The Standard now also specifies that a recumbent sleep surface be provided for at least one adult in these rooms.

Standard 11:  In light of the efficacy and increased use of waterless hand cleansers, the requirement that each single patient room have a handwashing station has been removed.  Each patient bed must still be within 20 feet of a handwashing sink so most designers will choose to place a sink inside a private room, but this change gives designers the option of situating the sink just outside the room based on their evaluation of the benefits and disadvantages of having a sink within the patient room.

Standard 14:  Unless provided elsewhere in the hospital, space must be provided in the NICU for feeding preparation, which should no longer be performed at the bedside.

Standard 22:  A requirement has been added to describe the allowable level of flicker in luminaires.

Standards 25 and 26:  The requirements for daylighting and access to nature have been clarified so that it will be clear that windows are not required for each patient room.  Our intent is to assure that daylighting and access to nature are readily accessible to families and staff.  These features are acceptable, even desirable in private rooms, but designers should not strive to provide windows in each private room if this means being unable to provide them in spaces frequented by adult caregivers and families.