Jamie R Macklin1, Michael A Gittelman2, Sarah A Denny3, Hayley Southworth4, Melissa Wervey Arnold4. 1. Divisions of Hospital Pediatrics and jamie.macklin@nationwidechildrens.org. 2. Division of Emergency Medicine, Cincinnati Children's Hospital, Cincinnati, Ohio; and. 3. Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio. 4. Ohio Chapter, American Academy of Pediatrics, Columbus, Ohio.
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.
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.
Authors: Ann Kellams; Margaret G Parker; Nicole L Geller; Rachel Y Moon; Eve R Colson; Emily Drake; Michael J Corwin; Mary McClain; W Christopher Golden; Fern R Hauck Journal: Pediatrics Date: 2017-10-13 Impact factor: 7.124
Authors: Terri J Miller; Trina C Salm Ward; Marcie M McClellan; Lisa Dawson; Kate Ford; Lauren Polatty; Rebecca L Walcott; Phaedra S Corso Journal: J Community Health Date: 2018-08
Authors: Jamie R Macklin; Gail Bagwell; Sarah A Denny; Jane Goleman; Julia Lloyd; Kris Reber; Linda Stoverock; Richard E McClead Journal: Pediatr Qual Saf Date: 2020-10-23