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dc.contributor.advisorRubarth, Lori B.en_US
dc.contributor.authorJelinek, Alyssaen_US
dc.date.accessioned2019-04-28T14:29:28Z
dc.date.available2020-05-18T08:40:22Z
dc.date.issued2019-05-18
dc.identifier.urihttp://hdl.handle.net/10504/122491
dc.description.abstractBackground: Premature infants are more likely than full term infants to die of Sudden Infant Death Syndrome (SIDS) or Sudden Unexpected Infant Death (SUID). The American Academy of Pediatrics (AAP) recommends that all infants 32 weeks and medically stable be placed in a safe sleep environment to allow adequate time of supine sleep prior to discharge. Due to premature infant’s unique needs requiring developmental care, specifically prone positioning and the use of developmental aids in the sleep environment, there is confusion of when and how to safely transition infants to supine sleep. Nurses report fears of aspiration, decreased respiratory effort, and discontentment of the infant as reasons for not placing an infant in supine sleep. Verbal education is relied on for education of safe sleep, while modeling the sleep environment in conjunction with verbal education is more effective. Parents are likely to model infant positioning practices of health care providers, potentially leading to unsafe sleep practices after discharge.|Purpose: The purpose of this evidence-based quality improvement project was to improve nurse compliance of AAP recommended safe sleep practices.|Methods: The setting was a 38-bed level IIIB neonatal intensive care unit in the Midwest. A multidisciplinary team including a neonatologist, neonatal nurse practitioner student, occupational therapist, and a bedside nurse revised the safe sleep policy, emphasizing the importance of transitioning to supine sleep, active tummy-time, and modeling of safe sleep in the crib environment to parents. An algorithm was developed to aid in position decision making utilizing gestational age and to clearly define medical stability when transitioning to safe sleep. Pre-education audits were completed to determine practice prior to education. In October of 2018 education was given to bedside nurses and neonatal developmental therapists. The education included policy changes, the need to transition to safe sleep, and modeling the safe sleep environment to parents. Post-education audits were performed on infants in cribs to determine effectiveness of education and included direct feedback.|Results: Safe sleep compliance increased from 21% (92 pre-intervention audits in May through July of 2018) to 82% (118 post-intervention audits in November and December of 2018). Monthly audits for compliance will continue until safe sleep compliance is greater than 90%. Once this is achieved, audits will continue on a quarterly basis to maintain compliance.|Implications for Practice: Policy revision, staff education, and bedside auditing with direct feedback increases safe sleep compliance in the neonatal intensive care unit.|Implications for Research: Additional research is needed to identify best practice in transitioning an infant to safe sleep, as well as effectiveness of supine sleep readiness tools and algorithms.|Keywords: safe sleep, premature, infant, SIDS, neonatal, developmentalen_US
dc.rightsCopyright is retained by the Author. A non-exclusive distribution right is granted to Creighton Universityen_US
dc.subject.meshSleepen_US
dc.subject.meshInfant, Prematureen_US
dc.subject.meshIntensive Care Units, Neonatalen_US
dc.subject.meshSudden Infant Deathen_US
dc.titleSafe Sleep in the NICUen_US
dc.rights.holderAlyssa Jelineken_US
dc.description.noteManuscripten_US
dc.embargo.terms2020-05-18
dc.degree.levelDNPen_US
dc.degree.disciplineDoctor of Nursing Practice (DNP) Programen_US
dc.degree.nameDoctor of Nursing Practiceen_US
dc.degree.committeePatrick, Nancyen_US


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