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This QI project was the development of a safe sleep program.

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Adoption of this program can be used in this hospital's mother-newborn unit, as well as to be put into practice at neighboring facilities.

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Qualitative results support NICU staff providing and demonstrating safe sleep programs which may decrease the incidence of SUIDs.

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This QI project is a mix of qualitative and quantitative research

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The interdisciplinary team implemented their new plan to the NICU staff in November-December of 2014.

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Inconsistent education of safe sleep practices provided by NICU staff to infant's caregivers.

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There is a lack of a standardized sleep program in the NICU.

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Zachritz, W., Fulmer, M., & Chaney, N. (2016). An evidence-based infant safe sleep program to reduce sudden unexplained infant deaths. AJN, American Journal of Nursing, 116(11), 48–55. https://doi.org/10.1097/01.naj.0000505590.78202.a2

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The NICU staff recognizes the importance of caregiver teaching, as well as documentation by the resulting 90% obtained on chart audits.

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Safe sleep practices were only taught 20% of the time by the NICU staff.

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Utilizing chart audits to determine compliance by the NICU staff with the new education guidelines. There were 216 audits performed in February and March, 2014.

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The QI project was used by the NICU staff to educate caregivers, and model positive behaviors prior to infant discharge.

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Members of the interdisciplinary team that developed the new process were responsible to teach all staff members: RN's, CNA's, Social Workers, Case Managers, and Respiratory Therapists.

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NICU staff found to follow unsafe sleep practices including:

Use of extra blankets over infant
Positioning devices
Infants positioned to sleep on their side and/or stomach.

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NICU staff provides teaching of a safe sleep program to

Parents/Caregivers of infants are able to practice this program at home.

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Two cases of SUIDs occured from infants that were discharged from NICU of this facility.

According to the CDC, in 2020 there were more than 1,000 deaths in U.S. related to SUIDs.

The American Acadamy of Pediatrics discourages the use of caps on infants, as this can lead to accidental strangulation or overheating.

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In-services were held in morning and evening in November and December for ease of staff to attend as required.

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The majority of the study relied on caregiver's reports regarding questions that were asked and their corresponding interventions. It is difficult to assign numbers or percentages to opinions.

The reliability and validity of a qualitative study without data collection and measurement techniques might be disputed in this QI project.

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Nurses demonstrated, via chart audit, 90% compliance with education of caregivers, modeling staff behaviors, and written documentation reinforcing this verbal education.

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Follow up calls were placed by members of the interdisciplinary team to assess the infant's home sleeping environment.

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NICU staff provides education and use of sleep sacks, models best practice behaviors for caregivers.

NICU staff will partner with outreach programs in the community.

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Teaching included:
Power point presentations
Demonstration of new practices/guidelines
Review by return demonstration/examination
Timeline until new change in new practice
Time allowed for question and answer session

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The author of this study found that a safe sleep program could be of benefit for all infants and caregivers in the facility, and potentially have widespread use to other organizations in the area.

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NICU staff practices safe sleep program 20% of the time prior to development of the new practice.

After development, the NICU staff practices safe sleep practice 90% of the time.

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Documentation by interdisciplinary team determined the greatest impact of the safe sleep program was the avoidance of co-sleeping, and sleeping on a flat surface.

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No infant deaths from SUIDs (sudden explained infant deaths) have occured during the calendar year.

NICU staff now follows up on discharge teaching by phone to the caregiver of infants.

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Preplanning occured during the last quarter of 2012.

Teaching the NICU staff by the interdisciplinary team was from November-December 2014.

Implementation of the new safe sleep program was initiated in January 2013.

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The unit director and his assistant were responsible for scheduling all members of the NICU staff to attend in-services, and recieve emails related to new practices to be implemented.