Sunday, June 24, 2012

Title: Now I Lay Me Back to Sleep....Safely

Woodrow Wilson (Gaylord National Harbor)
Courtnie J. Burrell, RNC , Neonatal Critical Care Center, Henrico Doctors' Hospital, Richmond, VA
Diane Stairs, RN , Neonatal Critical Care Center, Henrico Doctors' Hospital, Richmond, VA

Discipline: Newborn Care (N)

Learning Objectives:
  1. Nurses will model safe sleep positioning at least 24 hours prior to discharge.
  2. Nurses will review SIDS and SIDS risk reduction with the parents prior to discharge.
  3. Nurses will be able to apply safe sleep behaviors into their nursing practice.
Submission Description:
Purpose for the program:

One of the Healthy People 2020 goals is to improve the health and well-being of women, infants, children, and families. One way to accomplish this goal is by reducing the rate of fetal and infant deaths. In Virginia, from 2003 to 2007, there were approximately 78 infant deaths per year due to Sudden Infant Death Syndrome (SIDS). This is above the national average. It has been proven that supine sleeping is the greatest factor in reducing the risk of SIDS even though many nurses still feel more comfortable placing the baby prone. Hospital nurses are the first professional role models for new parents. Modeling suggested behaviors, such as back sleeping, can be a powerful education tool as well as parental education through verbal and written educational materials.

Proposed change:

Babies are no longer able to have stuffed animals or extra blankets in the incubator/crib. Once the baby is transitioned to an open crib, the baby should be placed in a supine position unless there is a physician’s order. Nurses are to model safe sleep positioning at least 24 hours prior to discharge and provide parental education on SIDS and SIDS risk reduction. SIDS education is also offered at infant CPR classes.

Implementation, outcomes and evaluation:

Safe sleep task force was initiated and a hospital policy on safe sleep was written. The staff received mandatory in-services regarding SIDS to ensure consistency in parental education. One in-service was on SIDS and SIDS risks in the term newborn and the other addressed the needs of the premature infant. Safe sleep education was added to the March of Dimes notebook all admissions to Neonatal Critical Care Center (NCCC) receive. This is reviewed with the parents prior to discharge.  An education record is signed at discharge acknowledging that the information was reviewed. After discharge the charts are retrospectively audited for safe sleep education and supine positioning at least 24 hours prior to discharge.

Implications for nursing practice:

The expectation is to provide consistent safe sleep education to the parents and to model safe sleep positioning. Data collected will be used to validate success of the program and to encourage the staff continued participation and support. Integrating evidence-based findings into practice will facilitate further involvement into addressing the higher incidence of SIDS in the African American population.

Keywords:

SIDS, safe sleep, model