Modeling of infant safe sleep practice in a newborn nursery: a quality improvement initiative

Abstract

Sudden infant death syndrome (SIDS) is a leading cause of infant mortality in the US. The American Academy of Pediatrics has provided recommendations for infant sleeping position and environment to decrease SIDS rates. These recommendations reinforce the importance of modeling safe sleep practices in the newborn nursery. Although many quality improvement initiatives have been undertaken to improve safe sleep in the nursery, such efforts are sparse in low-volume birth hospitals. This project aimed to improve infant sleep practices in a 10-bed level I nursery using visual cues (crib cards) and nursing education. We defined “safe sleep practice” if a newborn slept in a safe position in a flat bassinet and in a safe environment. We measured safe sleep practices before and after the intervention using an audit tool. As a result, safe sleep practices improved from 32% (30/95) preintervention to 75% (86/115) postintervention (P < 0.01). This study demonstrates that implementing a quality improvement initiative to improve infant sleep practices in a low-volume nursery is feasible and impactful.