An Evidence‐Based Safe Sleep Program Is Associated With Less Infant Sleep‐Related Deaths

• Published in: Worldviews on evidence-based nursing Vol. 22; no. 3; pp. e70022 - n/a
• Main Authors: Stringer, Marilyn, Lazzeri, Jessica, Giordano, Nicholas A., Polomano, Rosemary C., Quigley, Elizabeth, Ohnishi, Bonnie Renner, Fray, Marianne, Dunlevey, Elizabeth, Hoffman, Roy, Christ, Lori
• Format: Journal Article
• Language: English
• Published: United States 01.06.2025
• Subjects: Adult; Evidence-Based Practice - methods; Evidence-Based Practice - standards; evidence‐based; Female; Humans; Infant; infant safe sleep; infant sleep‐related deaths; Infant, Newborn; Male; maternal and child health; quality improvement; Sleep; Sudden Infant Death - epidemiology; Sudden Infant Death - prevention & control; sudden infant death syndrome; sudden unexpected infant death; Surveys and Questionnaires; United States; United States; maternal and child health; infant safe sleep; sudden unexpected infant death; quality improvement; sudden infant death syndrome; evidence‐based; infant sleep‐related deaths
• ISSN: 1545-102X; 1741-6787
• DOI: 10.1111/wvn.70022

ABSTRACT Background Sudden unexpected infant death (SUID) is a leading cause of infant mortality in the United States. Hospitals have implemented infant safe sleep programs with varying measures and degrees of success, but few have demonstrated improvements in hospital‐based and home safe sleep practices with nurse subject matter experts (SMEs) and community SUID prevention campaigns. Aims This project evaluated the impact of a state‐wide, evidence‐based infant safe sleep program for birthing hospitals using nurse SMEs and a community awareness campaign on nurse knowledge, safe sleep environments, and trends in infant sleep‐related deaths. Methods Between 2016 and 2021, a pre‐ and post‐test quality improvement intervention‐based design was used to enroll hospitals and train and embed SMEs to educate peers, conduct practice surveillance and audits, and address practice deviations. A website housed comprehensive resources, and a large‐scale community‐based social and print media campaign on safe sleep practices occurred. Nurse and practice data from 12 hospitals that fully implemented the program were compared pre‐ and post‐implementation. State‐wide survey data for key safe sleep indicators reported by parents were compared from our 12 birthing hospitals to other facilities. Results Of trained nurses (N = 902), 83.4% reported making substantial or exceptional progress in being proactive in surveillance of safe sleep environments. Pre‐ and post‐implementation environmental audits showed a significantly higher proportion of infants in safe sleep positions post‐implementation (94.3%) than pre‐implementation (89.6%) (p = 0.001). Statewide survey data from birth parents discharged from our program hospitals significantly outperformed those discharged from other state facilities. Multi‐media campaigns resulted in over 1.4 million impressions on our website. Sleep‐related deaths for infants born at four program hospitals dropped 16.1% from 31 in 2018 to 26 in 2021. Linking Evidence to Action A safe sleep program improved hospital‐based nurses' knowledge and practice and birth parent's knowledge and behaviors, and it was associated with a decrease in infant sleep‐related deaths.