Find Established Evidence

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), Training (Parent/Family), CAREGIVER, Education/Training (caregiver), Educational Material (caregiver), Sleep Environment Modification, PROVIDER/PRACTICE, Provider Training/Education, Educational Material (Provider), Nurse/Nurse Practitioner, Guideline Change and Implementation
Intervention Description: We evaluated a comprehensive hospital-based infant safe sleep education program on parental education and safe sleep behaviors in the home using a cross-sectional survey of new parents at hospital discharge (HD) and 4-month follow-up (F/U).
Conclusion: Reinforcing the infant sleep safety message through intensive hospital-based education improves parental compliance with sudden infant death syndrome risk reduction guidelines.
Study Design: Quasi-experimental nonequivalent control group design
Setting: Hospital, postpartum maternity units
Target Audience: Nurses + New parents
Data Source: Cross-sectional survey of parents at time of hospital discharge and at 4-month well-child visit
Sample Size: 1,092 in hospital sample 490 at 4-month follow-up
Age Range: Infant

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PARENT/FAMILY, Notification/Information Materials (Online Resources, Information Guide), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Provider Training/Education, Educational Material (Provider)
Intervention Description: The purpose of this study was to improve sleep position and environment in the hospital.
Conclusion: Using a multifaceted approach significantly improved infant safe sleep practice in the hospital setting.
Study Design: Pre-post intervention
Setting: Wesley Medical Center postpartum units
Target Audience: Nursing staff and mothers of infants
Data Source: Observation of sleep environment in hospital; follow-up parent survey
Sample Size: Baseline in hospital n=144 Post-intervention in hospital n=249 Parent survey n=101
Age Range: Infant

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROVIDER/PRACTICE, CAREGIVER, Educational Material (caregiver), Provider Training/Education, Nurse/Nurse Practitioner, HOSPITAL, Quality Improvement, Policy/Guideline (Hospital)
Intervention Description: The authors describe a 4-year demonstration project (2004-2007) to reduce infant deaths related to sleep environments by changing attitudes and practices among nurses who work with African American parents and caregivers in urban Michigan hospitals.
Conclusion: Following the policy change effort, nurses changed their behavior and placed infants on the back to sleep.
Study Design: QE: pretest-posttest
Setting: 7 maternity wards in urban hospitals in MI
Target Audience: Nursing staff and parents
Data Source: Crib audit; infant observation
Sample Size: Baseline: n=579 Follow-up: n=692
Age Range: Infant

NPM: 7-1: Child Safety/Injury (0-9 years) 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Policy/Guideline (Hospital), Quality Improvement, Continuing Education of Hospital Providers, Sleep Environment Modification, PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Provider Training/Education, CAREGIVER, Educational Material (caregiver)
Intervention Description: The dual aims of this project were to develop a safe sleep educational model for our neonatal intensive care unit (NICU), and to increase the percentage of eligible infants in a safe sleep environment.
Conclusion: With formal staff and family education, optional wearable blanket, and data sharing, safe sleep compliance increased and patient safety improved.
Study Design: QE: pretest-posttest
Setting: NICU
Target Audience: Neonatal nurses; staff Parents of newborns
Data Source: Crib audit/infant observation
Sample Size: 28 families at baseline 26 families at follow-up
Age Range: Infant

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): CAREGIVER, Education/Training (caregiver), PROVIDER/PRACTICE, Nurse/Nurse Practitioner, Quality Improvement/Practice-Wide Intervention
Intervention Description: To assess the effectiveness of 2 interventions separately and combined to promote infant safe sleep practices compared with control interventions.
Conclusion: Among mothers of healthy term newborns, a mobile health intervention, but not a nursing quality improvement intervention, improved adherence to infant safe sleep practices compared with control interventions. Whether widespread implementation is feasible or if it reduces sudden and unexpected infant death rates remains to be studied.

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, PROFESSIONAL_CAREGIVER, Education/Training (caregiver), HOSPITAL, Quality Improvement, Crib card, Audit/Attestation
Intervention Description: A multidisciplinary team developed a quality improvement initiative to create a hospital-based safe sleep environment for all newborns and infants prior to discharge. The safe sleep initiative included two key elements: (1) parent education about safe infant sleep that included verifying their understanding of safe sleep, and (2) modeling of safe infant sleep environment by hospital staff. To monitor compliance, documentation of parent education, caregiver surveys, and hospital crib check audits were tracked monthly. A visual safe sleep “crib ticket”—a checklist of safe sleep guidelines-- was placed at the bedside of newborns who were ready for supine positioning. Investigators used Plan-Do-Study-Act (PDSA) cycles to evaluate the impact of the initiative from October 2015 through February 2018.
Conclusion: WBN, NICU and general pediatric inpatient unit collaboration with content experts led to unit-specific strategies that improved safe sleep practices.
Significant Findings: Yes
Setting: Well-baby nursery (WBN) and NICU in an academic, quaternary care, regional referral center
Target Audience: Hospital staff

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, HOSPITAL, Quality Improvement
Intervention Description: The primary goals of the initiative were to improve nurses' adherence to the 2016 AAP safe sleep recommendations, including the supine infant sleep position, and to increase role modeling of a safe infant sleep environment. The initiative included a slide-show presentation on SUID, the AAP 2016 recommendations for infant safe sleep, rationale behind the recommendations, and common barriers to following the safe sleep guidance. The post-intervention evaluation included testing of nurses' knowledge, infant crib audits, and nurses' evaluation of the intervention.
Conclusion: Implementing a safe sleep initiative can increase nurses' knowledge, improve adherence to recommendations with modeling safe sleep practices, and increase parent awareness of safe sleep recommendations, potentially positively affecting adherence after discharge.
Significant Findings: Yes
Setting: Community hospital in a women's services unit
Target Audience: Full-time nurses and infant care technicians

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner
Intervention Description: The purpose of this quality improvement initiative was to increase the percentage of eligible infants being placed in safe sleep environments by registered nurses in a NICU. An evidence-based safe sleep bundle was developed and implemented in a level IV NICU at an academic medical center in the Southeastern United States. Data were subsequently collected for 5 months via biweekly crib audits.
Conclusion: SSPs should be endorsed and modeled in all NICUs. Introducing proper SSPs in the hospital setting may lead to better compliance at home by the infants' caregivers.
Significant Findings: Yes
Setting: Academic medical institution in Southeast U.S.
Target Audience: Registered nurses in NICU

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): PROFESSIONAL_CAREGIVER, Educational Material (caregiver), Provision of Safe Sleep Item, HOSPITAL, Quality Improvement, Crib Card, Policy/Guideline (Hospital), HEALTH_CARE_PROVIDER_PRACTICE, Educational Material (Provider), Nurse/Nurse Practitioner, Audit/Attestation, Audit/Attestation (Provider)
Intervention Description: This hospital quality improvement initiative performed a series of Plan-Do-Study-Act cycles designed to increase the proportion of infants placed in a “perfect sleep” environment that met all of the American Academy of Pediatrics’ infant safe sleep guidelines. The initiative took place while the hospital was preparing for Baby Friendly certification, with increased emphasis on rooming in and skin to skin at the same time. Initial cycles targeted nurse and parental education, while later cycles focused on providing sleep sacks/wearable blankets for the infants. The goal was to achieve 70% “perfect sleep” compliance among infants cared for in the hospital.
Conclusion: This project also suggests that infant safe sleep QI initiatives and preparation towards Baby Friendly Hospital Certification can be complementary.
Significant Findings: Yes
Target Audience: Hospital healthcare providers

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, Hospital, Quality Improvement, Audit/Attestation
Intervention Description: This descriptive study examined outcomes from 268 clinical nurses who received comprehensive education on infant safe sleep and their role as subject matter experts (SMEs). SME nurses completed two interactive learning modules addressing safe sleep guidelines and teaching strategies and attended a workshop to acquire skills for program implementation. Key competencies included data collection and dissemination, policy development, and communication techniques. Likert-type scale surveys measured knowledge gained and progress made in practice following education.
Conclusion: Use of the SME role for program implementation led to highly favorable SME-reported outcomes in leading a hospital-based QI program.
Significant Findings: No
Setting: 25 birthing hospitals in Pennsylvania
Target Audience: Nurses trained as subject matter experts (SMEs)

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Assessment (provider), Provider Training/Education, Nurse/Nurse Practitioner, PARENT/FAMILY, Education/Training (caregiver), Provision of Safe Sleep Item, HOSPITAL, Quality Improvement
Intervention Description: The purpose of our safe sleep initiative was to improve parental and staff knowledge of safe sleep practices and to achieve increased compliance with infant safe sleep in the hospital setting. A multidisciplinary team of health professionals was created to address poor compliance with safe sleep guidelines, investigate barriers, and identify primary drivers for improvement. Subsequent interventions included parent education, staff education, and improvements in system processes. Members of the hospitals nurse residency program conducted multidisciplinary surveys before and after the quality improvement initiative to assess staff knowledge of safe sleep practices. The data were collected prospectively.
Conclusion: We achieved improved compliance with safe sleep practices in our NN and NICU through education of staff and parents and improved system processes. We believe this will translate to improved safe sleep practices used by parents at home.
Significant Findings: Yes
Setting: Truman Medical Center in Kansas City
Target Audience: Infants admitted to newborn nursery and NICU

NPM: 5: Safe Sleep
Intervention Components (click on component to see a list of all articles that use that intervention): HEALTH_CARE_PROVIDER_PRACTICE, Provider Training/Education, Nurse/Nurse Practitioner, HOSPITAL, Quality Improvement, Sleep Environment Modification, Crib Card, Visual Display, Audit/Attestation
Intervention Description: A quality improvement (QI) model was developed to introduce the AAP guidelines on safe sleep (SS) practices into the NICU nursing practice in a consistent and sustainable method. The project team included the NICU hospitalist, a neonatologist, the Director of Newborn Services at the Wakefield Division, the nurse manager, two nurses, and a nurse practitioner. The team members met at monthly QI meetings to discuss progress for the duration of the project. Key drivers were identified, and the team used PDSA cycles to target interventions, which included a crib check tool and presentations by SS experts. One of the team’s main concerns during the initial deliberation sessions was the suboptimal temperature control in the NICU, and after meeting with the engineering staff, more sensors were placed in the NICU to eliminate the wide variations of temperatures throughout the day. The primary aim of the project was a 20% improvement in the SS compliance rates (from 7% to 27%) by December, 2017.
Conclusion: Multifactorial interventions significantly improved SS compliance among NICU nurses. Cultivating personal motivation among nurses, consistent empowerment and dedication to culture change by the entire team was crucial for the sustainability of the project.
Significant Findings: Yes
Setting: Wakefield neonatal service, Montefiore Medical Center