Coming Together to Save Babies: Our Institution’s Quality Improvement Collaborative to Improve Infant Safe Sleep Practices

Macklin, Jamie R.; Bagwell, Gail A.; Denny, Sarah; Goleman, Jane; Lloyd, Julia; Reber, Kris; Stoverock, Linda; McClead, Richard E.

doi:10.1097/pq9.0000000000000339

Cited by 5 publications

(9 citation statements)

References 9 publications

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“…However, these improvements have not translated to improved outcomes in sleep-related deaths at the population level. 15 Our unique care bundle also demonstrated significant improvements, although with some variability in secondary outcomes. This finding supports the hypothesis that a multi-pronged care bundle can effectively improve safe sleep for hospitalized infants.…”

Section: Discussionmentioning

confidence: 80%

“…However, this quality improvement study confirmed that targeted interventions and education could improve many aspects of safe sleep in the hospital environment, consistent with findings from other institutions. 5 , 15 , 18 – 21 The main areas of improvement at our institution included more infants sleeping in the crib, reduction in co-sleeping, head-of-bed position more often not elevated, reduction in the presence of home supplies in the crib (specifically blankets, pillows, and bottles), and an empty crib. We did not find significant improvements in infant sleep position (supine versus prone) or the presence of medical supplies in the crib.…”

Section: Discussionmentioning

confidence: 99%

“… 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. The specific aim was to increase the percentage of inpatient infants meeting the ABCs of safe sleep by 20% by December 2018 and sustain change for 6 months.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Salada

Arzu

Unti

et al. 2022

Pediatric Quality &Amp; Safety

View full text Add to dashboard Cite

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“…Further, our safe sleep audit is not a validated measuring system, although we made efforts to parallel sleep audits used in other studies to provide external validity. 14…”

Section: Discussionmentioning

confidence: 99%

Improving Adherence to Safe Sleep Guidelines for Hospitalized Infants at a Children’s Hospital

Molina

Harrison

Dye

et al. 2022

Pediatric Quality &Amp; Safety

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“…They further stress that providers should receive education on infant safe sleep and hospital policies should meet safe sleep standards ( 10 ). Prior to quality improvement efforts, only 0% to 32% of hospitalized infants slept in a safe environment ( 11 – 13 ). Improved adherence to safe sleep standards and modeling of safe sleep practices provide an opportunity to educate parents throughout their hospitalization.…”

Section: Introductionmentioning

confidence: 99%

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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Coming Together to Save Babies: Our Institution’s Quality Improvement Collaborative to Improve Infant Safe Sleep Practices

Abstract: Supplemental Digital Content is available in the text.

Cited by 5 publications

References 9 publications

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

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

Improving Adherence to Safe Sleep Guidelines for Hospitalized Infants at a Children’s Hospital

Missed Opportunities: Healthcare Encounters Prior to Sudden Unexpected Infant Death

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