Improving Safe Sleep Modeling in the Hospital through Policy Implementation
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FROM THE FIELD
Improving Safe Sleep Modeling in the Hospital through Policy Implementation Rachel Heitmann1 · Ester K. Nilles1 · Ashley Jeans1 · Jackie Moreland3 · Chris Clarke3 · Morgan F. McDonald1 · Michael D. Warren2
© Springer Science+Business Media, LLC 2017
Abstract Introduction Sleep-related infant deaths are major contributors to Tennessee’s high infant mortality rate. The purpose of this initiative was to evaluate the impact of policy-based efforts to improve modeling of safe sleep practices by health care providers in hospital settings across Tennessee. Methods Safe sleep policies were developed and implemented at 71 hospitals in Tennessee. Policies, at minimum, were required to address staff training on the American Academy of Pediatrics’ safe sleep recommendations, correct modeling of infant safe sleep practices, and parent education. Hospital data on process measures related to training and results of crib audits were compiled for analysis. Results The overall observance of infants who were found with any risk factors for unsafe sleep decreased 45.6% (p ≤ 0.001) from the first crib audit to the last crib audit. Significant decreases were noted for specific risk factors, including infants found asleep not on their back, with a toy or object in the crib, and not sleeping in a crib. Significant improvements were observed at hospitals where printed materials or video were utilized for training staff compared to face-to-face training. Discussion Statewide implementation of the hospital policy intervention resulted in significant reductions in infants found in unsafe sleep situations. The most common risk factors for sleep-related * Rachel Heitmann [email protected] 1
Division of Family Health and Wellness, Tennessee Department of Health, Andrew Johnson Tower, 8th floor, 710 James Robertson Parkway, Nashville, TN 37243, USA
2
Tennessee Department of Health, Andrew Johnson Tower, 5th Floor, 710 James Robertson Parkway, Nashville, TN 37243, USA
3
Tennessee Hospital Association, 5201 Virginia Way, Brentwood, TN 37027, USA
infant deaths can be modeled in hospitals. This effort has the potential to reduce sleep-related infant deaths and ultimately infant mortality. Keywords Safe sleep · Safe sleep hospital policy · Back to sleep
Significance Educational interventions aimed at increasing staff knowledge and compliance with infant safe sleep recommendations has been shown to be effective at changing hospital staff behavior. Moreover, studies suggest that parents are likely to imitate infant sleep practices modeled by health care providers in a hospital setting. This study describes a successful statewide public health initiative which resulted in all birthing hospitals voluntarily instituting safe sleep policies modeled after the AAP recommendations, training their perinatal staff on the recommendations, having staff model correct infant sleep practices and educating parents on safe sleep.
Introduction In 2013, 23,440 infants died in the United States and approximately 15% (3434) of t
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