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The EASE Project Revisited: Improving Safe Sleep Practices in Ohio Birthing and Children's Hospitals
Jamie R Macklin1, Michael A Gittelman2, Sarah A Denny1
11 Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Hospitalized infants often lack safe sleep environments. A quality improvement program significantly increased safe infant sleep practices in children's hospitals and birthing centers.
Area of Science:
- Pediatrics
- Quality Improvement Science
- Public Health
Background:
- Hospitalized infants frequently lack adherence to recommended safe sleep environments.
- Current safe sleep practices are suboptimal in pediatric and birthing hospital settings.
Purpose of the Study:
- To implement and evaluate a quality improvement program aimed at enhancing safe sleep practices for hospitalized infants.
- To increase compliance with American Academy of Pediatrics safe sleep recommendations across diverse hospital settings.
Main Methods:
- Recruited hospitalists into an Ohio American Academy of Pediatrics collaborative.
- Utilized a standardized audit tool to assess infant sleep environments.
- Implemented three Plan-Do-Study-Act (PDSA) cycles to drive improvements in safe sleep behaviors.
Main Results:
- Safe sleep compliance in children's hospitals increased from 37.0% to 59.6% (P < .01).
- Compliance in birthing centers rose from 59.3% to 72.5% (P < .01).
- Infants in birthing centers demonstrated higher compliance with safe sleep practices compared to those in children's hospitals.
Conclusions:
- A collaborative quality improvement program effectively enhances safe infant sleep practices in hospitals.
- Quality improvement initiatives are crucial for improving infant safety in healthcare settings.
- Birthing centers showed greater adherence to safe sleep guidelines than children's hospitals.
Abstract:
Literature has shown hospitalized infants are not often observed in recommended safe sleep environments. Our objective was to implement a quality improvement program to improve compliance with appropriate safe sleep practices in both children's and birthing hospitals. Hospitalists from both settings were recruited to join an Ohio American Academy of Pediatrics collaborative to increase admitted infant safe sleep behaviors. Participants used a standardized tool to audit infants' sleep environments. Each site implemented 3 PDSA (Plan-Do-Study-Act) cycles to improve safe sleep behaviors. A total of 37.0% of infants in children's hospitals were observed to follow the current American Academy of Pediatrics recommendations at baseline; compliance improved to 59.6% at the project's end (P < .01). Compliance at birthing centers was 59.3% and increased to 72.5% (P < .01) at the collaborative's conclusion. This study demonstrates that a quality improvement program in different hospital settings can improve safe sleep practices. Infants in birthing centers were more commonly observed in appropriate sleep environments than infants in children's hospitals.
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