Abstract
Background: Sudden unexpected infant death (SUID) results in thousands of deaths in the United States annually. Rates of sudden infant death syndrome (SIDS) have decreased, but other types of sleep related deaths (SRD) are increasing. Premature infants are, significantly, more at risk for SRD. Although NICU therapeutic positioning (NTP) may be indicated early in hospitalization, medically stable NICU patients can be found in unsafe sleep environments after 32-weeks corrected gestational age, against clear guidelines from the American Academy of Pediatrics (AAP).|Problem: Many NICU caregivers do not transition to Safe Sleep Practices (SSP), which leads to mixed messaging for parents and does not facilitate a smooth transition for Safe Sleep upon discharge.|Purpose: The purpose of this QI project was to implement a multidisciplinary program to support appropriate transition from NTP to SSP at the appropriate time for eligible infants.|Methods: The project included guideline/algorithm development and implementation, staff and parent education, visual cues, swaddle sacks and EMR standing orders and documentation. Knowledge acquisition was evaluated by descriptive comparison of pre- and post-education tests. Compliance was measured by analysis of EMR audits and pre- and post-intervention bedside audits.|Results: Overall knowledge of AAP Safe Sleep recommendations increased from 65% to 88%. Compliance with appropriate positioning improved from 81% to 94% from pre- to post-project implementation, respectively.|Conclusion: These compliance rates, which are higher than previously reported, are thought to be due to the multidisciplinary involvement, cues, and facilitation by EMR standard orders and documentation.