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Implementing a Hospital-Based Safe Sleep Program for Newborns and Infants
Patricia A Patrick1, Jennifer F Canter, Heather L Brumberg
1Westchester Institute for Human Development, Valhalla, New York (Drs Patrick and Canter); School of Health Sciences and Practices, New York Medical College, Valhalla (Drs Patrick and Brumberg); Department of Pediatrics, New York Medical College, Valhalla (Drs Patrick, Canter, Brumberg, LaGamma, and Altman); and Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, New York (Drs Canter, Brumberg, Sandhu, Trinidad, LaGamma, and Altman, Mss Dozor and Smith, and Mr Aboudi).
Insights
Implementing a hospital-based safe sleep initiative significantly improved infant safe sleep practices in well-baby nurseries and NICUs. This quality improvement effort enhanced caregiver education and compliance with safe sleep guidelines.
Area of Science:
- Pediatrics
- Public Health
- Quality Improvement Science
Background:
- Unsafe infant sleep environments are a primary cause of unexpected infant mortality.
- Establishing safe sleep practices is crucial for infant well-being.
Purpose of the Study:
- To assess the effectiveness of a hospital-based quality improvement initiative aimed at creating safe sleep environments for all newborns and infants.
- To enhance safe sleep practices within hospital settings before infant discharge.
Main Methods:
- A multidisciplinary team implemented safe sleep initiatives in well-baby nurseries (WBN) and neonatal intensive care units (NICU).
- Data collection included parent education documentation, caregiver surveys, and hospital crib audits.
- Plan-Do-Study-Act (PDSA) cycles were used to evaluate the initiative's impact from October 2015 to February 2018.
Main Results:
- Parental reporting of safe infant sleep information was high (95.4%).
- Initial compliance with safe sleep criteria was 0% in WBN and NICU, and 8.3% in general pediatric units.
- After 29 months, WBN and NICU compliance reached 90% and 100%, respectively; general pediatric unit compliance reached 20% after 7 months.
Conclusions:
- Collaborative, unit-specific strategies developed with content experts effectively improved safe sleep practices.
- The initiative demonstrated success in enhancing safe sleep environments within hospital settings.
- Further research is recommended to evaluate similar initiatives in other healthcare facilities.
Background:
An unsafe sleep environment remains the leading contributor to unexpected infant death.
Purpose:
To determine the effectiveness of a quality improvement initiative developed to create a hospital-based safe sleep environment for all newborns and infants.
Methods:
A multidisciplinary team from the well-baby nursery (WBN) and neonatal intensive care unit (NICU) of a 149-bed academic, quaternary care, regional referral center developed and implemented safe sleep environments within the hospital for all prior to discharge. To monitor compliance, the following were tracked monthly: documentation of parent education, caregiver surveys, and hospital crib check audits. On the inpatient general pediatric units, only hospital crib check audits were tracked. Investigators used Plan-Do-Study-Act (PDSA) cycles to evaluate the impact of the initiative from October 2015 through February 2018.
Results:
Safe sleep education was documented for all randomly checked records (n = 440). A survey (n = 348) revealed that almost all caregivers (95.4%) reported receiving information on safe infant sleep. Initial compliance with all criteria in WBN (n = 281), NICU (n = 285), and general pediatric inpatient units (n = 121) was 0%, 0%, and 8.3%, respectively. At 29 months, WBN and NICU compliance with all criteria was 90% and 100%, respectively. At 7 months, general pediatric inpatient units' compliance with all criteria was 20%.
Implications For Practice:
WBN, NICU and general pediatric inpatient unit collaboration with content experts led to unit-specific strategies that improved safe sleep practices.
Implications For Research:
Future studies on the impact of such an initiative at other hospitals are needed.
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