Safe Sleep Recommendations Research Articles

Evaluation of Community Baby Showers to Promote Safe Sleep

Background. In recent years, Kansas has ranked 40th among all states for worst infant mortality rates. For African American infant mortality, Kansas had the highest rate in the nation. Because of these statistics, initiatives have been implemented to reduce these rates by the KIDS Network, in partnership with the Black Nurses Association and the National Association of Hispanic Nurses. The purpose was to describe participants’ knowledge and intentions regarding safe sleep following a Community Baby Shower. Methods. The Community Baby Shower was targeted to African American women via black churches, physician offices, clinics, black sororities, word of mouth, radio, and print. All Baby Shower participants were asked to complete a brief survey following the shower. Results. The majority were African American (61%) with a high school diploma or less schooling (63%). Nearly all (97%) planned to place their baby supine for sleep. However, less than half (47%) planned to have the baby sleep in the parents’ room in a separate crib. Attendees exhibited high levels of safe sleep knowledge, stated intentions to utilize most safe sleep recommendations, and reported babies would have slept in unsafe environments without the portable crib. Conclusions. Our Baby Showers were attended by the target audience, who exhibited high levels of safe sleep knowledge, and stated intentions to utilize most safe sleep recommendations following the Shower. However, some participants were resistant to following at least some of the recommendations. Additional venues and other educational strategies may be needed to maximize the uptake of these recommendations.

Endorsing Safe Sleep: Helping Nurses Turn Recommendations Into Reality

<h2>Newborn Care Poster Presentation</h2><h3>Purpose for the Program</h3> Sudden infant death syndrome (SIDS) is now considered preventable. Since 1992, the recommendations of the American Academy of Pediatrics (AAP) for SIDS prevention or safe sleep have been considered best practice. In 2011, AAP published an expanded list of safe sleep recommendations. Neonatal nurses are now being asked to endorse these strategies from the time of birth. Multiple studies have described inconsistent safe sleep practices among hospital nurses, which leads to confusion for parents. SIDS prevention efforts have been hindered by neonatal nurses' failure to model safe sleep behaviors and educate parents. Furthermore, some of the recommendations have been met with resistance, with other so‐called experts creating controversy and skepticism. This controversy has created significant barriers and added to the confusion for both nurses and parents, creating a difficult learning environment. The purpose of this program was to not only teach nurses the safe sleep recommendations, but to also address the controversy and provide answers to their concerns. <h3>Proposed Change</h3> The safe sleep program of this maternal–newborn unit was developed to educate and convince nursing staff that SIDS can be prevented. These nurses would then be prepared and motivated to convince parents of the need to follow the safe sleep recommendations. <h3>Implementation, Outcomes, and Evaluation</h3> This program was designed as a nursing competency that was slowly implemented over a 1‐year period, with the content broken into four modules. A pretest was given before the first module. After the first module, which was an overview of all the strategies, key unsafe sleep practices were identified and a list of nursing practices that needed to be modified was provided. In the months following, in‐depth information on each strategy was provided, resources were created to assist with the education of parents, and crib audits were performed to monitor progress. At the end of the year a post test showed marked improvement of nurses' knowledge and crib audits showed marked improvement of safe sleep behaviors modeled by nurses. <h3>Implications for Nursing Practice</h3> The United States and New Zealand have the highest rates of SIDS and other sleep‐related deaths among developed nations. Safe sleep recommendations are considered best practice, yet neonatal nurses have been slow to implement them. Working to break through the barriers and controversy with evidence and dialogue will move us toward a unified endorsement of the safe sleep recommendations.

Endorsing Safe Infant Sleep

The American Academy of Pediatrics (AAP) safe sleep recommendations are considered best practice and are effective in preventing sudden infant death syndrome (SIDS). Yet studies have found that nurses’ practice in newborn nurseries and neonatal intensive care units is often inconsistent with safe sleep recommendations. Such inconsistencies cause confusion and hinder SIDS prevention efforts. In 2011, the AAP added significant content to its 2005 safe sleep recommendations and neonatal nurses are now being asked to endorse the recommendations from birth. This article reviews the recommendations, examines barriers and controversies and offers suggestions for how an organization might initiate change and move toward a unified endorsement of safe sleep strategies.

Sudden Infant Death Syndrome: An Update

Sudden Infant Death Syndrome: An Update

Qualitative Analysis of Beliefs and Perceptions about Sudden Infant Death Syndrome in African-American Mothers: Implications for Safe Sleep Recommendations

To investigate, by using qualitative methods, perceptions about sudden infant death syndrome (SIDS) in African-American parents and how these influence decisions. Eighty-three mothers participated in focus groups or individual interviews. Interviews probed reasons for decisions about infant sleep environment and influences affecting these decisions. Data were coded, and themes were developed and revised in an iterative manner as patterns became more apparent. Themes included lack of plausibility, randomness, and vigilance. Many mothers believed that the link between SIDS and sleep position was implausible. Because the cause of SIDS was unknown, they did not understand how certain behaviors could be defined as risk factors. This confusion was reinforced by perceived inconsistency in the recommendations. Most mothers believed that SIDS occurred randomly ("God's will") and that the only way to prevent it was vigilance. Many African-American mothers may not understand the connection between SIDS and sleep behaviors or believe that behavior (other than vigilance) cannot affect risk. These beliefs, if acted on, may affect rates of safe sleep practices. Efforts to explain a plausible link between SIDS and safe sleep recommendations and to improve consistency of the message may result in increased adherence to these recommendations.

JNMA Salutes New NMA Members Recently Elected to the World’s Most Elite Surgical Society

The aims of this quality improvement initiative were to increase parental knowledge of safe sleep recommendations and sudden infant death syndrome (SIDS) prevention and assess parental compliance with safe sleep recommendations for preterm infants discharged from the Neonatal Intensive Care Unit (NICU).Parents received an educational session and a safe sleep handout. Pre-test, post-test, and one-month follow-up questionnaires were completed by parents. Scores were recorded before and after the educational session and one month after hospital discharge.Safe sleep educational sessions before hospital discharge resulted in higher post-test scores compared with pre-test scores and a high percentage of compliance to safe sleep practices at home.The educational session and safe sleep handout increased parental knowledge of safe sleep recommendations and SIDS prevention and resulted in significant compliance to safe sleep practices at home.

Membership Application

The aims of this quality improvement initiative were to increase parental knowledge of safe sleep recommendations and sudden infant death syndrome (SIDS) prevention and assess parental compliance with safe sleep recommendations for preterm infants discharged from the Neonatal Intensive Care Unit (NICU).Parents received an educational session and a safe sleep handout. Pre-test, post-test, and one-month follow-up questionnaires were completed by parents. Scores were recorded before and after the educational session and one month after hospital discharge.Safe sleep educational sessions before hospital discharge resulted in higher post-test scores compared with pre-test scores and a high percentage of compliance to safe sleep practices at home.The educational session and safe sleep handout increased parental knowledge of safe sleep recommendations and SIDS prevention and resulted in significant compliance to safe sleep practices at home.

Reducing the Risk of Sudden Infant Death Syndrome in Child Care and Changing Provider Practices: Lessons Learned From a Demonstration Project

The goal was to evaluate, through an American Academy of Pediatrics demonstration project, the effectiveness of a curriculum and train-the-trainer model in changing child care providers' behaviors regarding safe infant sleep practices. Participating licensed child care centers and family child care homes were assigned randomly to intervention and control groups. Observers performed an initial unannounced visit to each site, to watch infants being placed for sleep, to inventory sleep policies, and to administer questionnaires to center staff members. Trainers then used the American Academy of Pediatrics curriculum in educational sessions at intervention sites. Three months later, observers conducted a follow-up observation at each site, and staff members completed a questionnaire about logistic barriers encountered in implementation of safe sleep recommendations. A total of 264 programs and 1212 providers completed the study; the care of 1993 infants was observed. Provider awareness of the American Academy of Pediatrics infant supine sleep position recommendation increased from 59.7% (both groups) to 64.8% (control) and 80.5% (intervention). Exclusive use of the supine position in programs increased from 65.0% to 70.4% (control) and 87.8% (intervention). Observed supine placement increased from 51.0% to 57.1% (control) and 62.1% (intervention). A sudden infant death syndrome risk reduction curriculum using a train-the-trainer model is effective in improving the knowledge and practices of child care providers. Perceived parental objections, provider skepticism about the benefits of supine positioning, and lack of program policies and training opportunities are important barriers to implementation of safe sleep policies. Continued education of parents, expanded training efforts, and statewide regulations, mandates, and monitoring are critical to ongoing efforts to decrease further the risk of sudden infant death syndrome in child care.

Physician Recommendations Regarding SIDS Risk Reduction: A National Survey of Pediatricians and Family Physicians

Sudden infant death syndrome (SIDS) is a leading cause of death among infants. Recently, new SIDS risk factors have emerged. To determine knowledge and recommendations of pediatricians and family physicians regarding SIDS-relevant practices. Cross-sectional survey of 3005 pediatricians and family physicians. Of the 783 respondents, pediatricians comprised 64% and females 52%; 78% recognized supine as the recommended sleep position; 69% recommended supine. Almost all physicians recommended a firm mattress, 82% recommended a crib or bassinet, and 42% recommended a separate room for infants; 63% had no preference about or did not recommend restricting pacifier use. Pediatricians were more likely to discuss infant sleep position and room sharing at every well-child visit. Knowledge about recommended infant sleep position is relatively high, but there are gaps in physician knowledge regarding safe sleep recommendations. Greater dissemination of information is required, and barriers to implementation need to be identified and addressed.