Partnering with Parents: Preventing Infant Falls

In-Hospital Newborn Falls Associated With a Sleeping Parent: The Case for a New Paradigm

“…It is involuntary and unavoidable. 52 In one anecdotal report, it was recounted that a mother fell asleep 2,5,10,13,14,18,19,36 for the duration of the feeding, to keep the newborn safe. Paternal exhaustion [43][44][45] would preclude using fathers.…”

“…Data revealed that 50% to 100% of the newborn falls occurred during nighttime feedings. 1,2,5,7,11,15,20,24,29 The prevailing wisdom was that sleeping with an infant was unsafe. 41,42 A sleeping parent feeding or holding an infant was interpreted as nonadherence with the American Academy of Pediatrics (AAP) safe sleep guidance.…”

“…They included parental and staff education about safe sleep practices, ‡ frequent rounding, ‖ promotion of maternal rest, { parental signature on an infant safety pledge, # instruction to mothers to ask for assistance if feeling sleepy, ** reminder signage about safe sleep practices, † † identification of high risk mothers, ‡ ‡ and assignment or request for an alert individual to be present during nighttime feedings. 1,3,5,6,10,18,25,37 The strategies in the NSBs (Table 1) were focused on staff detection of a sleepy mother to remove the infant before she fell asleep and educate the mother about safe sleep practices. The premise was that a well-informed mother would stay awake or call for help if she felt sleepy.…”

Fall prevention in our healthiest patients: Assessing risk and preventing injury for moms and babies

“…In response to an increase in infant falls or drops, Winthrop University Hospital (New York) instituted a Newborn Safety Partnering Agreement for Parents as an element of their infant fall prevention program . The Agreement, along with the discussion with staff, raises parent awareness of the potential for falls and when and why they are more likely to occur.…”

“…Implementation of the Agreement was found to be most successful when it was initiated before delivery. Since implementation of this Agreement, the unit has been successful in eliminating infant falls . A similar initiative was undertaken at St. Francis Hospital (Connecticut), where in addition to a Safety Pledge signed by the parents, they implemented hourly rounds, infant safety signage, promotion of maternal rest, and parent teaching .…”