Maternal and Child Health Journal

, 12:363

First online:

Changing Hospital Newborn Nursery Practice: Results from a Statewide “Back to Sleep” Nurses Training Program

  • Sarah Kye PriceAffiliated withSchool of Social Work, Virginia Commonwealth UniversitySIDS Resources, Inc Email author 
  • , Pamela GardnerAffiliated withTruman State University
  • , Laura HillmanAffiliated withUniversity of Missouri ColumbiaSIDS Resources, Inc
  • , Karen SchenkAffiliated withMissouri Department of Health and Senior Services
  • , Carrie WarrenAffiliated withSIDS Resources, Inc

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In response to findings from a statewide survey of hospital nurses, the authors designed, conducted, and evaluated a “Back to Sleep” nursing curriculum and training program in Missouri hospitals using two distinct training formats. This article evaluates the initial and follow-up outcomes for training participants and assesses the impact of training format on participant outcomes.


Participants selected training format by hospital site. In each training format, participants responded to a pre and post test questionnaire measuring knowledge, beliefs, and current infant care behaviors as well as satisfaction with the training. Three months after completion of all statewide trainings, the authors also conducted a follow-up survey.


Nurses who participated in the training reported statistically significant improvements in knowledge and “Back to Sleep” adherent beliefs. Over 98% of participants (N = 515) intended to place infants in back-only sleep positions following the training. Knowledge, attitudes, and practice intentions were significantly improved across both training formats. Additionally, follow-up survey respondents statewide (N = 295) reported lasting improvements, including 63% of nurses reportedly using supine-only sleep position for infants after the first 24 h of life, compared to 28% in the original statewide survey.


Further research is needed to determine the long-term impact of this intervention and assess its applicability beyond this initial implementation. Ultimately, the findings from the evaluation of this pilot intervention and nursing-specific “Back to Sleep” curriculum demonstrate that it has a promising effect on risk-reduction adherence in hospital settings where parent observations of safe sleep behavior first occur.


Sudden Infant Death Syndrome (SIDS) Health education Risk reduction Nursing practice Hospitals Infant health and safety Safe sleep Infant sleep position Back to Sleep (BTS) American Academy of Pediatrics (AAP)