Integration of safe sleep and sudden infant death syndrome (SIDS) education among parents of preterm infants in the Neonatal Intensive Care Unit (NICU)

https://doi.org/10.1016/j.jnn.2016.09.001Get rights and content

Abstract

Purpose

The aims of this quality improvement initiative were to increase parental knowledge of safe sleep recommendations and sudden infant death syndrome (SIDS) prevention and assess parental compliance with safe sleep recommendations for preterm infants discharged from the Neonatal Intensive Care Unit (NICU).

Methods

Parents received an educational session and a safe sleep handout. Pre-test, post-test, and one-month follow-up questionnaires were completed by parents. Scores were recorded before and after the educational session and one month after hospital discharge.

Results

Safe sleep educational sessions before hospital discharge resulted in higher post-test scores compared with pre-test scores and a high percentage of compliance to safe sleep practices at home.

Conclusion

The educational session and safe sleep handout increased parental knowledge of safe sleep recommendations and SIDS prevention and resulted in significant compliance to safe sleep practices at home.

Introduction

Sudden infant death syndrome (SIDS) remains the third leading cause of infant mortality in the United States (Gelfer et al., 2013). Despite a major decrease in the incidence of SIDS since the AAP released its recommendation that infants be placed for sleep in a supine position, this decline has plateaued in recent years (Moon, 2011). Although there has been substantial compliance with the AAP recommendations, many parents continue to place their infants at risk for SIDS from lack of knowledge and understanding of SIDS prevention recommendations (Carrier, 2009).

Premature and low-birth-weight infants have a higher risk of SIDS than term infants and very-low-birth-weight infants are more likely to sleep in the non-supine position after discharge than larger low-birth-weight infants (Gelfer et al., 2013). Prone or side sleep positions increases risk for premature infants who are three to six times more at risk for SIDS than term infants (Carrier, 2009). Parental knowledge and acceptance of safe sleep practices are critical to decreasing the risk of unexpected deaths (Gelfer et al., 2013). Studies demonstrate that providing current written material along with modeling safe sleep practices can help further reduce the incidence of SIDS (Grazel et al., 2010).

Previous literature has shown that it is important to educate parents of preterm and term infants on the risks of SIDS and safe sleep practices. The interventions also support providing current written material along with modeling safe sleep practices to further reduce the incidence of SIDS. Safe sleep practices are modeled prior to discharge with infants in the NICU at Magee Womens Hospital (MWH) of UPMC, however written detailed information regarding the risk of SIDS for preterm infants and recommended safe sleep practices are not currently provided to parents before discharge to home.

A literature search was conducted to find and integrate evidence on the effectiveness of SIDS and safe sleep written education before hospital discharge to support a change in clinical practice. One database was searched (PubMed) using the following search terms: SIDS, sudden infant death syndrome, safe sleep education, neonatal ICU, preterm. Four relevant articles were identified. The four studies reviewed found that providing verbal and written education to parents of premature infants prior to hospital discharge had shown post-education improvement and significantly increased parental knowledge of SIDS and safe sleep recommendations. The studies also found a significant increase in the percentage of parental compliance to safe sleep practices (Carrier, 2009, Gelfer et al., 2013, Grazel et al., 2010, McMullen et al., 2009). This quality improvement (QI) initiative utilized this research evidence to support a change in clinical practice after showing a need for standardized educational practice regarding safe sleep parent education for use in the NICU at MWH.

The purposes of this project were to increase parental knowledge of SIDS and safe sleep recommendations, measure parental compliance to safe sleep practices of premature infants after hospital discharge, and establish a change in clinical practice for discharge education for parents of preterm infants in the NICU.

Section snippets

Design

A one group pre-post design with a 1-month follow up questionnaire was used. Data collection begun March 1, 2016 and was completed by May 1, 2016. Approval for this QI initiative was granted by the Evidence Based Practice council at MWH. University of Pittsburgh Institutional Review Board approval was not required.

Setting and sample

The setting was a 74-bed Level III NICU in a full-service women's hospital, MWH of UPMC, which serves as the leading teaching facility for the University of Pittsburgh. More than

Results

As shown in Table 1, all questions, with the exception of questions one and six, from the pre-post questionnaires showed a significant increase in knowledge post educational session. Questions one and six were answered 100% correctly on both the pre and post questionnaires therefore did not have any measurable knowledge change. Questions two and three had a 7.5% score increase, question four had a 27.5% score increase, question five had a 22.5% score increase, and question seven had a 40.0%

Discussion

The findings supported receiving safe sleep and SIDS education for parents of preterm infants in the NICU before hospital discharge. Parental knowledge of safe sleep recommendations and compliance to safe sleep practices were both significantly higher post written and verbal education. The results supported previous findings that providing current written material along with modeling safe sleep practices in the hospital prior to discharge to home can help further reduce the incidence of SIDS.

Conclusions

The AAP recommends that parents of both term and preterm infants receive verbal and written education about SIDS and ways to reduce the risk of SIDS before discharge to home. Providing current written material along with modeling safe sleep practices in the hospital prior to discharge to home can help further reduce the incidence of SIDS (Grazel et al., 2010). Thus, it is very important to incorporate safe sleep and SIDS education into discharge instruction for parents of preterm infants in the

Funding

This project received no external funding.

Conflict of interest

The authors declare no conflict of interest.

References (5)

There are more references available in the full text version of this article.

Cited by (0)

View full text