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Integrating "Back to Sleep" recommendations into neonatal ICU practice

Polina Gelfer1, Ricci Cameron, Kathy Masters

  • 1Division of Neonatal-Perinatal Medicine, The University of Texas at Houston Medical School, 6431 Fannin St, Houston, TX 77030, USA. polina.gelfer@uth.tmc.edu

Pediatrics
|March 6, 2013
PubMed

Insights

Multifactorial interventions significantly improved safe sleep practices in Neonatal Intensive Care Units (NICUs) and at home. This led to better infant sleep positioning and reduced risks for sudden infant death syndrome.

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.
Abstract

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