Improving Safe Sleep Environments for Well Newborns in the Hospital Setting

Abstract

Objective. Following the “Back to Sleep” campaign, deaths from sudden infant death syndrome (SIDS) were reduced. However, SIDS and sleep-related deaths continue to occur. Studies demonstrate that modeling by health care workers influences parents to place infants supine for sleep. Recently, additional emphasis has been placed on environment. The purpose of this study was to improve sleep position and environment in the hospital. Methods. A Plan-Do-Study-Act cycle was initiated. Sleeping infants were observed at baseline. A bundled intervention was implemented; infants were again observed. Parents were surveyed. Results. At baseline, 25% (36/144) of sleeping infants were safe; the majority of unsafe sleep was a result of environment. Postintervention, significantly more (58%; 145/249) had safe sleep (P < .0001). Most parents planned to use the supine position (95%; 96/101); none planned to cosleep. Many intended to adjust their infants’ home sleep environment. Conclusion. Using a multifaceted approach significantly improved infant safe sleep practice in the hospital setting.

Keywords

safe sleep infant mortality SIDS quality improvement

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References

Central Intelligence Agency World Factbook. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html. Accessed June 13, 2012.

Shapiro-Mendoza

Kimball

Tomashek

. US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984-2004: are rates increasing? Pediatrics. 2009;123:533.

Schnitzer

Covington

Dykstra

. Sudden unexpected infant deaths: sleep environment and circumstances. Am J Public Health. 2012;102:1204-1212.

Task Force on Sudden Infant Death Syndrome. Policy statement. SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics. 2011;128:1030-1039.

Bullock

Mickey

Green

. Are nurses acting as role models for the prevention of SIDS. MCN Am J Matern Child Nurs. 2004;29:172-177.

Colson

Bergman

Shapiro

. Position for newborn sleep: associations with parents’ perceptions of their nursery experience. Birth. 2001;28:249-253.

Stastny

Ichinose

Thayer

. Infant sleep positioning by nursery staff and mothers in newborn hospital nurseries. Nurs Res. 2004;53:122-129.

Shaefer

Herman

Frank

. Translating infant safe sleep evidence into nursing practice. J Obstet Gynecol Neonatal Nurs. 2010;39:618-626.

Zachry

Kitzmann

. Disparities in sleep position awareness and compliance. South Med J. 2010;103:311-315.

10.

Aris

Stevens

Lemura

. NICU nurses’ knowledge and discharge teaching related to infant sleep position and risk of SIDS. Adv Neonatal Care. 2006;6:340.

11.

Moon

Oden

Joyner

. Qualitative analysis of beliefs and perceptions about sudden infant death syndrome in African-American mothers: implications for safe sleep recommendations. J Pediatr. 2010;157:92-97.

12.

Robida

Moon

. Factors influencing infant sleep position: decisions do not differ by SES in African-American families. Arch Dis Child. 2012;97:900-905.

13.

Smith

Colson

Rybin

. Maternal assessment of physician qualification to give advice on AAP-recommended infant sleep practices to SIDS. Acad Pediatr. 2010;10:383-388.

14.

Kaskutas

Graves

. Relationship between cumulative exposure to health messages and awareness and behavior-related drinking during pregnancy. Am J Health Promot. 1994;9:115-124.

15.

Colson

Rybin

Smith

. Trends and factors associated with infant sleeping position: the national infant sleep position study, 1993-1997. Arch Pediatr Adolesc Med. 2009;163:1122-1128.

16.

Von Kohorn

Corwin

Rybin

. Influence of prior advice and beliefs of mothers on infant sleep position. Arch Pediatr Adolesc Med. 2010;164:363-369.