Improving Compliance With Safe Sleep Guidelines for Vulnerable Patients in a Community Safety Net Hospital Neonatal...

Area of Science:

• Neonatal care
• Pediatric safety
• Quality improvement in healthcare

Background:

• Unsafe sleep practices are a leading cause of preventable infant mortality.
• Many infants in the neonatal intensive care unit (NICU) experience unsafe sleep conditions.
• Establishing safe sleep modeling in the NICU can improve post-discharge parental adherence.

Purpose of the Study:

• To increase compliance with safe sleep recommendations in level II and III NICUs.
• To improve adherence to national safe sleep guidelines for infants over 32 weeks gestation.
• To achieve an 85% weekly compliance rate with safe sleep standards by March 2025.

Main Methods:

• Implemented a multi-cycle Plan-Do-Study-Act (PDSA) quality improvement project.
• Included education for residents, fellows, and nurses on NICU safe sleep standards.
• Introduced non-reclined cribs and bedside reminder signs.

Main Results:

• Achieved a significant increase in mean compliance with safe sleep practices.
• Mean compliance rose from a baseline of 58% to 91% post-intervention.
• Exceeded the study aim of 85% compliance.

Conclusions:

• The interventions successfully enhanced safe sleep compliance among NICU nursing staff.
• Future efforts will focus on embedding safe sleep practices into the NICU culture for sustainability.
• Ongoing strategies include promoting "nursing safe sleep champions," regular audits, and using sleep sacks.