Integrating "Back to Sleep" recommendations into neonatal ICU practice

Area of Science:

• Pediatrics
• Neonatal Care
• Public Health

Background:

• The American Academy of Pediatrics recommends NICUs model safe sleep practices before infant discharge.
• Healthcare providers' sleep positioning practices influence parental behavior at home.
• NICU staff are critical role models for parents regarding infant sleep safety.

Purpose of the Study:

• To increase adherence to safe sleep practices in the NICU before infant discharge.
• To assess if improved NICU compliance influences parental safe sleep practices at home.

Main Methods:

• Developed a quality improvement intervention including an algorithm for safe sleep initiation, educational materials, and a crib audit tool.
• Implemented "Back to Sleep" campaigns and postdischarge telephone reminders.
• Utilized a postdischarge telephone survey to assess parental compliance.

Main Results:

• NICU compliance with supine infant positioning increased from 39% to 83% (P < .001).
• Provision of a firm sleeping surface increased from 5% to 96% (P < .001).
• Parental compliance with safe sleep practices improved from 23% to 82% (P < .001) post-discharge.

Conclusions:

• Multifactorial interventions effectively enhanced safe sleep compliance within the NICU.
• These interventions also positively influenced parental safe sleep practices after discharge.
• Improved NICU practices contribute to better infant sleep safety at home.