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Related Experiment Video

Updated: Aug 12, 2025

Multi-Modal Home Sleep Monitoring in Older Adults
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Improving Safe Infant Sleep Compliance Through Implementation of a Safe Sleep Bundle.

Alicia M Sacks1, Jennifer Fitzgerald, Laura A Boerste

  • 1Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Sacks and Ms Boerste); and University of Maryland School of Nursing, Baltimore (Dr Fitzgerald).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|January 26, 2023
PubMed
Summary

Implementing a safe sleep bundle in the neonatal intensive care unit (NICU) significantly improved staff compliance with safe infant sleep practices. This initiative aims to reduce sleep-related deaths in high-risk infants.

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Area of Science:

  • Neonatal care
  • Public health
  • Quality improvement initiatives

Background:

  • Sleep-related infant deaths pose a significant public health risk, particularly for premature infants discharged from the neonatal intensive care unit (NICU).
  • The American Academy of Pediatrics recommends safe sleep practices, acknowledging unique NICU challenges.

Purpose of the Study:

  • To implement a safe sleep bundle in a level III NICU.
  • To evaluate the bundle's effectiveness in enhancing caregiver compliance with safe sleep practices.

Main Methods:

  • A pre- and post-analysis quality improvement initiative was conducted.
  • Infants >= 32 weeks post-menstrual age in a level III NICU were assessed.
  • The safe sleep bundle included policy updates, standardized sleep sacks, educational materials, and an electronic health record (EHR) order set.

Main Results:

  • Overall safe sleep compliance significantly improved to 100% post-intervention from a baseline of 18%.
  • The P-value for the improvement was .029.

Conclusions:

  • Clinical staff role-modeling can decrease the risk of sleep-related infant deaths.
  • A multifactorial approach is effective for enhancing safe sleep compliance in NICU settings.