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Journal Article

Citation

Macklin JR, Gittelman MA, Denny SA, Southworth H, Arnold MW. Pediatrics 2016; ePub(ePub): ePub.

Affiliation

Ohio Chapter, American Academy of Pediatrics, Columbus, Ohio.

Copyright

(Copyright © 2016, American Academy of Pediatrics)

DOI

10.1542/peds.2015-4267

PMID

27630074

Abstract

BACKGROUND: Despite American Academy of Pediatrics (AAP) recommendations, many hospitalized infants are not observed in the appropriate safe sleep environment. Caregivers tend to model sleep patterns observed in a hospital setting. This project assessed the change in infant safe sleep practices within 6 children's hospitals after the implementation of a statewide quality improvement program.

METHODS: The AAP recruited hospitalists from each of the state's children's hospitals and asked them to form "safe sleep teams" within their institutions. Teams used a standardized data tool to collect information on the infant's age and sleep position/environment. They collected baseline data and then weekly for the duration of the 12-month project. Teams were required to implement at least 3 Plan-Do-Study-Act cycles. We calculated changes in safe sleep practices over time. Providers received Maintenance of Certification Part IV credit for participation.

RESULTS: Teams collected 5343 audits at all participating sites. At baseline, only 279 (32.6%) of 856 of the sleeping infants were observed to follow AAP recommendations, compared with 110 (58.2%) of 189 (P <.001) at the project's conclusion. The presence of empty cribs was the greatest improvement (38.1% to 67.2%) (P <.001). Removing loose blankets (77.8% to 50.0%) (P <.001) was the most common change made. Audits also showed an increase in education of families about safe sleep practices from 48.2% to 75.4% (P <.001).

CONCLUSIONS: Multifactorial interventions by hospitalist teams in a multi-institutional program within 1 state's children's hospitals improved observed infant safe sleep behaviors and family report of safe sleep education. These behavior changes may lead to more appropriate safe sleep practices at home.

Copyright © 2016 by the American Academy of Pediatrics.


Language: en

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