Background: 

The American Academy of Pediatrics (AAP) encourages healthcare providers to practice and model safe sleep practices (SSPs) in the neonatal intensive care unit (NICU) when it is developmentally and medically appropriate for the infant. Preintervention data were collected as a baseline prior to the quality improvement (QI) initiative and revealed that 87% of eligible infants were in unsafe sleep environments (n = 331/379). This data revealed the need for an improvement project to help increase the percentage of infants placed in safe sleep in this NICU.

Purpose: 

The purpose of this QI initiative was to increase the percentage of eligible infants being placed in safe sleep environments by registered nurses in a NICU.

Methods: 

The development of an evidence-based safe sleep bundle was implemented in a level IV NICU at an academic medical center in the Southeastern United States. Data were subsequently collected for 5 months via bi weekly crib audits.

Results: 

Of the 744 infants audited in the QI period, 604 were observed in a safe sleep environment. From the pre- to postintervention period, SSPs increased by 68% (preintervention: 13%, postintervention: 81%, P value < .001). Adherence to the varying components of SSPs also reflected statistically significant improvements.

Implications for Practice: 

SSPs should be endorsed and modeled in all NICUs. Introducing proper SSPs in the hospital setting may lead to better compliance at home by the infants' caregivers.

中文翻译：

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增加新生儿重症监护病房的安全睡眠习惯

背景： 

美国儿科学会 (AAP) 鼓励医疗保健提供者在新生儿重症监护室 (NICU) 在发育和医学上适合婴儿的情况下实践和模拟安全睡眠实践 (SSP)。在质量改进 (QI) 计划之前收集干预前数据作为基线，结果显示 87% 符合条件的婴儿处于不安全的睡眠环境中 (n = 331/379)。该数据表明需要一个改进项目来帮助提高该 NICU 中婴儿安全睡眠的百分比。

目的： 

这项 QI 计划的目的是增加 NICU 注册护士将符合条件的婴儿置于安全睡眠环境中的百分比。

方法： 

美国东南部一家学术医疗中心的 IV 级新生儿重症监护病房实施了基于证据的安全睡眠包的开发。随后通过双周婴儿床审计收集了 5 个月的数据。

结果： 

在 QI 期间审核的 744 名婴儿中，有 604 名在安全的睡眠环境中被观察到。从干预前到干预后，SSP 增加了 68%（干预前：13%，干预后：81%，P值 <.001）。遵守 SSP 的不同组成部分也反映了统计上的显着改进。

实践意义： 

SSP 应在所有 NICU 中得到认可和建模。在医院环境中引入适当的 SSP 可能会提高婴儿护理人员在家中的依从性。