Our Babies Are Looking at the Stars: Changing Nursing Culture to Ensure Safe Sleep Practices During Hospitalization

Our Babies Are Looking at the Stars:
Changing Nursing Culture to Ensure Safe Sleep Practices During Hospitalization

The American Academy of Pediatrics (AAP) issued a policy statement in November 2005 stating they no longer recognized side sleeping as an appropriate sleep position for infants.  Also addressed in this policy statement were safe sleep environments for infants, including no soft bedding or soft objects in the crib.  Our hospital incorporated these recommendations into their newborn policy.  Nurses were informed of the policy change through staff meetings.

Concern was expressed that nurses were not following policy. While the AAP recommendations were being taught to parents, nursing staff were reluctant to change their practice. The parents, although educated on safe sleep practices, saw the professional nursing staff continuing to place infants on their sides. Nurses are important role models who should demonstrate safe sleep to families of newborns.  A safe sleep committee was formed to change nursing culture regarding infant sleep practices.  Observational audits of our newborn nurseries revealed only 46% of babies were on their back.  When the nurses were questioned their response was they feared the infant would aspirate.  The committee made several recommendations: re-educate staff, designate a safe sleep champion for each shift, place resource manuals on the units, and have posters promoting safe sleep placed on the units. Education was planned in a cost-effective innovative manner that minimized non-productive hours.  A 50 hour continuous open house was held when staffing patterns were heaviest.  A PowerPoint presentation was developed to provide consistent information.  Free food was obtained.  135 staff attended the open house which represented 100% of the scheduled postpartum staff and many staff from labor and delivery and high risk antepartum. Only 11 hours of non-productive time were utilized.

Post education audits were astonishing, 87% of babies were on their back.  Safe sleep champions continue in their roles on all three shifts.  Future audits are planned. This poster illustrates how a different approach to education and dissemination of information can change deep rooted nursing behaviors.  Details of the education process will be shared.