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Safe Infant Sleep Interventions: What is the Evidence for Successful 
 Behavior Change?

View Article: PubMed Central - PubMed

ABSTRACT

Sudden infant death syndrome (SIDS) and other sleep-related infant deaths, such as accidental suffocation and strangulation in bed and ill-defined deaths, account for >4000 deaths annually in the USA. Evidence-based recommendations for reducing the risk of sleep-related deaths have been published, but some caregivers resist adoption of these recommendations. Multiple interventions to change infant sleep-related practices of parents and professionals have been implemented. In this review, we will discuss illustrative examples of safe infant sleep interventions and evidence of their effectiveness. Facilitators of and barriers to change, as well as the limitations of the data currently available for these interventions, will be considered.

No MeSH data available.


Model for Improvement, adapted from Institute for Health Care Improvement and the Health Resources and Services Administration [34].
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License
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Figure 1: Model for Improvement, adapted from Institute for Health Care Improvement and the Health Resources and Services Administration [34].

Mentions: Quality improvement (QI) programs are used by most hospitals to systematically and continuously implement small, incremental changes in policy and practice, such that changes lead to measurable improvements in healthcare delivery and outcomes [33]. The goal is to standardize and improve care so that it is more efficient and effective. The cornerstone of many QI programs is the Model for Improvement (Fig. 1) [34], which uses the Plan-Do-Study-Act (PDSA) cycle: Once a practice needing improvement is identified, staff create a PLAN for a small, incremental change. Staff then make the change in their practice (DO) and STUDY the results of this change by assessing through observational audits whether there is an improved outcome. Finally, the staff ACT by discussing what worked and didn’t work, and develop a new PLAN. The cycle thus repeats itself on a continuous basis. PDSA cycles are generally rapid cycles, with observational audits occurring on a weekly or biweekly basis. Recently, hospitals have been using QI methodology to improve safe infant sleep practices [35]. For example, staff may report that 60% of infants have thick blankets in their bassinets. The PLAN may be to coach nurses on strategies to talk to parents about the dangers of thick blankets. The nurses then use these strategies for 1 week (DO), followed by observational audits to determine if there is a change (STUDY). Finally, the team discusses what worked and what didn’t (ACT), modifies the plan to achieve a better result, and the cycle starts again. One study reported that using QI methodology in a NICU resulted in increases in supine positioning (from 39% to 83%, p<0.001) and firm sleep surfaces (from 5% to 96%, p<0.001), and decreases in soft objects in the infant sleep area (from 45% to 75%, p=0.001). Parental adherence with safe sleep practices after NICU discharge also improved from 23% to 82% (p<0.001) [36].


Safe Infant Sleep Interventions: What is the Evidence for Successful 
 Behavior Change?
Model for Improvement, adapted from Institute for Health Care Improvement and the Health Resources and Services Administration [34].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4997961&req=5

Figure 1: Model for Improvement, adapted from Institute for Health Care Improvement and the Health Resources and Services Administration [34].
Mentions: Quality improvement (QI) programs are used by most hospitals to systematically and continuously implement small, incremental changes in policy and practice, such that changes lead to measurable improvements in healthcare delivery and outcomes [33]. The goal is to standardize and improve care so that it is more efficient and effective. The cornerstone of many QI programs is the Model for Improvement (Fig. 1) [34], which uses the Plan-Do-Study-Act (PDSA) cycle: Once a practice needing improvement is identified, staff create a PLAN for a small, incremental change. Staff then make the change in their practice (DO) and STUDY the results of this change by assessing through observational audits whether there is an improved outcome. Finally, the staff ACT by discussing what worked and didn’t work, and develop a new PLAN. The cycle thus repeats itself on a continuous basis. PDSA cycles are generally rapid cycles, with observational audits occurring on a weekly or biweekly basis. Recently, hospitals have been using QI methodology to improve safe infant sleep practices [35]. For example, staff may report that 60% of infants have thick blankets in their bassinets. The PLAN may be to coach nurses on strategies to talk to parents about the dangers of thick blankets. The nurses then use these strategies for 1 week (DO), followed by observational audits to determine if there is a change (STUDY). Finally, the team discusses what worked and what didn’t (ACT), modifies the plan to achieve a better result, and the cycle starts again. One study reported that using QI methodology in a NICU resulted in increases in supine positioning (from 39% to 83%, p<0.001) and firm sleep surfaces (from 5% to 96%, p<0.001), and decreases in soft objects in the infant sleep area (from 45% to 75%, p=0.001). Parental adherence with safe sleep practices after NICU discharge also improved from 23% to 82% (p<0.001) [36].

View Article: PubMed Central - PubMed

ABSTRACT

Sudden infant death syndrome (SIDS) and other sleep-related infant deaths, such as accidental suffocation and strangulation in bed and ill-defined deaths, account for &gt;4000 deaths annually in the USA. Evidence-based recommendations for reducing the risk of sleep-related deaths have been published, but some caregivers resist adoption of these recommendations. Multiple interventions to change infant sleep-related practices of parents and professionals have been implemented. In this review, we will discuss illustrative examples of safe infant sleep interventions and evidence of their effectiveness. Facilitators of and barriers to change, as well as the limitations of the data currently available for these interventions, will be considered.

No MeSH data available.