Sleep Safety for Pediatric Inpatients: A Quality Improvement Success Story
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A multidisciplinary workgroup organized to standardize the safe sleep practices of infants less than one year of age. Through a quality improvement project interventions were aimed for staff, parent and community education and purchase of safe products to reduce risks for SIDS after discharge.
Relevance/Significance:
Sudden Infant Death Syndrome (SIDS) is the leading cause of death for infants 1-12 months of age in the US. Two modifiable ways to reduce the risk for SIDs are removal of unsafe objects from the sleeping infants' cribs and back positioning. Interventions were developed to improve the safety of the infant sleep environments at our hospital. Hospitals with patients < 1 year of age will benefit from ways to improve safe sleep environments in their setting and after discharge.
Strategy and Implementation:
The multidisciplinary workgroup examined current sleep practices and unit-specific SIDS protocols. Safe sleep literature was reviewed and summarized. An observational before-and-after study surveyed infants less than 12 months of age on inpatient units. Infants were surveyed in August 2013 and again in August 2014. Reviewing the 2013 data, the workgroup identified four areas for focus. Products: sleep sacks were purchased to replace crib blankets and storage bins were purchase to store unsafe objects such as washcloths, wipes, and thermometers out of the beds. Staff education: a module about infant safe sleep guidelines was created and made mandatory for all pediatric nurses and available for other disciplines. Parent education: current materials were reviewed. Laminated crib cards were created to remind caregivers and parents to lay babies down on their backs for safe sleep. Community: The Safe Sleep message was shared at numerous venues within the hospital and local community.
Evaluation:
In 2013, 82% (18/22) of sleeping infants had safe positioning. Fifteen infants (68%) had unsafe objects in their cribs. In 2014 95% (35/37) had safe sleep positioning. Thirteen infants (35%) had objects in their cribs. There was no statistical change with positioning (82% vs. 95%, p=0.183). We had a significant decrease in the number of cribs with unsafe objects 68% vs. 35%, p= 0.017).
Implications for Practice:
Thru the work of a multidisciplinary workgroup vested in safety, significant changes can be made to decrease the risk for SIDs and increase the safe sleep environment for infants.