Steering the Titanic: One tertiary care children's hospital's experience navigating safe sleep for hospitalized infants

Background: Sudden Unexpected Infant Death (SUID) is the leading cause of death in infants 1 month to 1 year of age in the United States. Despite extensive efforts in research and public education, rates of sleep-related infant death have plateaued since the late-1990s, largely due to unsafe sleep practices and environments.Local problem: A multidisciplinary team assessed our institution's compliance with its own infant safe sleep pol-icy. Data was collected on infant sleep practices, nurses' knowledge and training on the hospital policy, and teach-ing practices for parents and caregivers of hospitalized infants. Zero crib environments from our baseline observation met all the American Academy of Pediatrics recommendations for infant safe sleep.Methods: A comprehensive safe sleep program was implemented in a large pediatric hospital system. The pur-pose of this quality improvement project was to improve compliance with safe sleep practice from 0% to 80%, documentation of infant sleep position and environment every shift from 0% to 90%, and documentation of care-giver education from 12% to 90% within 24 months. Interventions: Interventions included revision of hospital policy, staff education, family education, environmental modifications, creation of a safe sleep taskforce, and electronic health record modifications.Results: Documented compliance with infant safe sleep interventions at the bedside improved from 0% to 88%, while documentation of family safe sleep education improved from 12% to 97% during the study period.Conclusions: A multifaceted, multidisciplinary approach can lead to significant improvements in infant safe sleep practices and education in a large tertiary care children's hospital system.(c) 2023 Elsevier Inc. All rights reserved.