Sleeping Safe and Sound: A Multidisciplinary Hospital-wide Infant Safe Sleep Quality Improvement Initiative

J Pediatr Health Care. 2024 Jul-Aug;38(4):604-614. doi: 10.1016/j.pedhc.2024.02.007. Epub 2024 Apr 20.

Abstract

Introduction: Promoting safe sleep to decrease sudden unexpected infant death is challenging in the hospital setting.

Local problem: Concern for adherence to safe sleep practice across inpatient units at a large pediatric hospital.

Methods: Used quality improvement methodologies to promote safe sleep across all units.

Interventions: Development of a multidisciplinary expert group, hospital-wide guidelines, targeted interventions, and bedside audits to track progress.

Results: Adherence to safe sleep practices improved from 9% to 53%. Objects in the crib were a major barrier to maintaining a safe sleep environment. Safe sleep practices were less likely to be observed in infants with increased medical complexity (p = .027).

Conclusions: Quality improvement methodology improved adherence to infant safe sleep guidelines across multiple units. Medically complex infants continue to be a challenge to safe sleep. Therefore, ongoing education for staff and further research into best practices for the most complex infant populations are necessary.

Keywords: Sudden infant death; clinical audit; inpatient; intervention; sudden unexpected infant death.

MeSH terms

  • Female
  • Guideline Adherence*
  • Hospitals, Pediatric*
  • Humans
  • Infant
  • Infant Care / methods
  • Infant Care / standards
  • Infant, Newborn
  • Male
  • Patient Safety / standards
  • Practice Guidelines as Topic
  • Quality Improvement*
  • Sleep / physiology
  • Sudden Infant Death* / prevention & control