A Hospital-Based Initiative to Reduce Postdischarge Sudden Unexpected Infant Deaths

Krugman, Saul; Cumpsty-Fowler, Carolyn

doi:10.1542/hpeds.2017-0211

Cited by 18 publications

(14 citation statements)

References 11 publications

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“…Historically, SUID and safe sleep educational efforts were focused on the NICU and newborn nursery encounters ( 7 ). Our results suggest a need to re-balance these efforts to include outpatient primary care practices (the most frequent presentation in our cohort) and inpatient hospitalizations (where length of stay provides multiple opportunities for education and modeling).…”

Section: Discussionmentioning

confidence: 99%

“…Healthcare professionals are uniquely positioned to educate new parents about infant safe sleep at every encounter. Safe sleep initiatives have historically targeted nursery care and neonatal intensive care unit (NICU) hospitalizations, with nursery-based safe sleep programs successfully resulting in reduced average SUID rates post-intervention ( 7 ). Studies addressing safe sleep during outpatient primary care physician visits, inpatient general pediatric admissions, and emergency room visits are limited, however promising new data shows that parent knowledge and practice of infant safe sleep are influenced by in-hospital interventions, with parents more likely to place their infants in a supine position and use a crib following intensive hospital educational efforts ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Missed Opportunities: Healthcare Encounters Prior to Sudden Unexpected Infant Death

Salada

Badke

2022

Front. Pediatr.

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IntroductionSudden unexpected infant death (SUID) is the leading cause of death in children 28 days to 1 year of age. The study aim was to identify opportunities for healthcare professionals to provide families with education on sleep and prevention of SUID.MethodsWe performed a retrospective chart review of SUID infants over 10 years (12/2010–12/2020). The study included patients 0–12 months who presented to single institution with SUID (including asphyxia, suffocation, and SIDS). Baseline descriptive characteristics, sleep patterns (location, position, co-sleeping, presence of pillows/blankets), and prior healthcare encounters (type, duration, frequency, timing) were described.ResultsThirty-five infants met inclusion criteria. Twenty-three percent of families routinely practiced unsafe sleep, while 63% practiced unsafe sleep at the time of SUID. All unsafe sleep behaviors increased during the SUID event compared to routine, including inappropriate location (60%), co-sleeping (46%), and inappropriate position (37%) at the time of SUID. There were 54 total healthcare encounters (mean 1.5 per patient +/− 2.1) prior to SUID. Primary care physicians (57%) and NICU (29%) were the most frequent prior healthcare encounters, however visits spanned multiple specialties. Twenty-six percent had a healthcare encounter within 7 days of their death.DiscussionWe demonstrated the frequency and variability in healthcare encounters among SUID infants prior to their death. Majority of infants had prior healthcare encounters, with 26% seen by healthcare professionals within 7 days of their death. These results highlight the important role healthcare professionals across all specialties have the potential to play in educating families about safe sleep and SUID.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Missed Opportunities: Healthcare Encounters Prior to Sudden Unexpected Infant Death

Salada

Badke

2022

Front. Pediatr.

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“…Algorithms that account for some of the variables discussed in this report have been developed on the basis of literature review, expert opinions, and unit consensus. 14,251 254 The authors concluded that repeated messaging and education by the entire nursery staff has the potential to play a role in reducing sleep-related deaths in infants born at a hospital.…”

Section: Human Milk and Breastfeedingmentioning

confidence: 99%

Transition to a Safe Home Sleep Environment for the NICU Patient

et al. 2021

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Of the nearly 3.8 million infants born in the United States in 2018, 8.3% had low birth weight (<2500 g [5.5 lb]) and 10% were born preterm (gestational age of <37 completed weeks). Many of these infants and others with congenital anomalies, perinatally acquired infections, and other disease require admission to a NICU. In the past decade, admission rates to NICUs have been increasing; it is estimated that between 10% and 15% of infants will spend time in a NICU, representing approximately 500 000 neonates annually. Approximately 3600 infants die annually in the United States from sleep-related deaths, including sudden infant death syndrome International Classification of Diseases, 10th Revision (R95), ill-defined deaths (R99), and accidental suffocation and strangulation in bed (W75). Preterm and low birth weight infants are particularly vulnerable, with an incidence of death 2 to 3 times greater than healthy term infants. Thus, it is important for health care professionals to prepare families to maintain their infant in a safe sleep environment, as per the recommendations of the American Academy of Pediatrics. However, infants in the NICU setting commonly require care that is inconsistent with infant sleep safety recommendations. The conflicting needs of the NICU infant with the necessity to provide a safe sleep environment before hospital discharge can create confusion for providers and distress for families. This technical report is intended to assist in the establishment of appropriate NICU protocols to achieve a consistent approach to transitioning NICU infants to a safe sleep environment as soon as medically possible, well before hospital discharge. INTRODUCTIONAccording to the 2016 policy statement from the American Academy of Pediatrics (AAP) Task Force on Sudden Infant Death Syndrome, all infants, including preterm and low birth weight infants, in the NICU should be placed in the supine position for sleep as soon as they are

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“… 11 , 12 Nursery-based safe sleep programs have reduced average SUID death rates postintervention. 13 However, recent research suggests that infants are not placed in safe sleep environments when admitted to a hospital, resulting in a new focus on targeting safe sleep within hospital policies. 14 , 15 The objectives of this study were to analyze the sleep practices of hospitalized infants, assess adherence to the AAP safe sleep guidelines, and develop interventions to improve adherence to these guidelines at our hospital.…”

Section: Introductionmentioning

confidence: 99%

Practicing What We Preach: An Effort to Improve Safe Sleep of Hospitalized Infants

Salada

Arzu

Unti

et al. 2022

Pediatric Quality &Amp; Safety

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Introduction: To prevent sudden unexpected infant death, pediatric providers recommend the ABCs of infant sleep: Alone, on the Back, and in an empty Crib. This study’s objective was to document sleep practices of infants admitted to a large children’s hospital, examine adherence to American Academy of Pediatrics safe sleep guidelines, and develop interventions to improve guideline adherence. Methods: We conducted a pre/post quality improvement study at a single quaternary care medical center from 2015 to 2019. Infants 0 to younger than 12 months were observed in their sleeping environment pre- and post-implementation of multiple hospital-wide interventions to improve the sleep safety of hospitalized infants. Results: Only 1.3% of 221 infants observed preintervention met all ABCs of safe sleep; 10.6% of 237 infants met the ABCs of safe sleep postintervention. Significant improvements in the post-intervention cohort included sleeping in a crib (94% versus 80% preintervention; P < 0.001), avoidance of co-sleeping (3% versus 15% preintervention; P < 0.001), absence of supplies in the crib (58% versus 15% preintervention; P < 0.001), and presence of an empty crib (13% versus 2% preintervention; P < 0.001). Conclusions: Most infants hospitalized at our institution do not sleep in a safe environment. However, the implementation of a care bundle led to improvements in the sleep environment in the hospital. Further research is necessary to continue improving in-hospital safe sleep and to assess whether these practices impact the home sleep environment.

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A Hospital-Based Initiative to Reduce Postdischarge Sudden Unexpected Infant Deaths

Cited by 18 publications

References 11 publications

Missed Opportunities: Healthcare Encounters Prior to Sudden Unexpected Infant Death

Missed Opportunities: Healthcare Encounters Prior to Sudden Unexpected Infant Death

Transition to a Safe Home Sleep Environment for the NICU Patient

Practicing What We Preach: An Effort to Improve Safe Sleep of Hospitalized Infants

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