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

  • Sarah Kye Price
  • Pamela Gardner
  • Laura Hillman
  • Karen Schenk
  • Carrie Warren
Article

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

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) 

References

  1. 1.
    Bullock, L. F., Mickey, K., Green, J., & Heine, A. (2004). Are Nurses Acting as Role Models for Prevention of SIDS?. MCN. The American Journal Of Maternal Child Nursing, 29(3), 172–7.PubMedCrossRefGoogle Scholar
  2. 2.
    American Academy of Pediatrics Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. (2000). Changing concepts of sudden infant death syndrome: Implication for infant sleeping environment and sleep position. Pediatrics, 105:650–656.CrossRefGoogle Scholar
  3. 3.
    Leach, C. E. A., Blair, P. S., Fleming, P. J., et al. (1999). Sudden unexpected deaths in infancy Similarities and differences in the epidemiology of SIDS and explained deaths. Pediatrics, 104, e43.PubMedCrossRefGoogle Scholar
  4. 4.
    Fleming, P. J., Blair, P. S., & Bacon, C. (1996). Environment of infants during sleep and risk of the sudden infant death syndrome: Results of 1993–5 case control study for confidential inquiry into stillbirths and deaths in infancy. British Medical Journal, 313, 191–195.PubMedGoogle Scholar
  5. 5.
    Mitchell, E. A., Tuohy, P. G., Brunt, J. M., Thompson, J., Clements, M. S., & Stewart, A. W. (1997). Risk factors for sudden infant death syndrome following the prevention campaign in New Zealand: A prospective study. Pediatrics, 100, 835–840.PubMedCrossRefGoogle Scholar
  6. 6.
    Parmet, S., Lynm, C., & Glass, R. (2002). Sudden infant death syndrome. JAMA, 288, 2772.PubMedCrossRefGoogle Scholar
  7. 7.
    Blair, P. S., Platt, M. W., Smith, I. J., Fleming, P. J., & CESDI SUDI Research Group. (2006). Sudden infant death syndrome and sleeping position in pre-term and low birth weight infants: an opportunity for targeted intervention. Archives of Disease in Childhood, 91, 101–106.Google Scholar
  8. 8.
    Carpenter, R. G., Irgens, L. M., Blair, P. S., England, P. D., Fleming, P., Huber, J., Jorch, G., & Schreuder, P. (2004). Sudden unexplained infant death in 20 regions of Europe: case control study. Lancet, 363, 185–191.PubMedCrossRefGoogle Scholar
  9. 9.
    Li, D. K., Petitti, D. B., Willinger, M., McMahon, R., Odouli, R., Vu, H., & Hoffman, H. J. (2003). Infant sleeping position and the risk of sudden infant death syndrome in California, 1997–2000. American Journal of Epidemiology, 157, 446–455.PubMedCrossRefGoogle Scholar
  10. 10.
    Thompson, J. M., Thatch, B. T., Becroft, D. M., & Mitchell, E. A. (2006). New Zealand Cot Death Study Group. Sudden infant death syndrome: risk factors for infants found face down differ from other SIDS cases. Journal of Pediatrics, 149, 630–633.PubMedCrossRefGoogle Scholar
  11. 11.
    Ostfeld, B. M., Perl, H., Esposito, L., Hempstead, K., Hinnen, R., Sandler, A., Pearson, P. G., & Hegvi, T. (2006). Sleep environment, positional, lifestyle, and demographic characteristics associated with bed sharing in sudden infant death syndrome: a population-based study. Pediatrics, 118, 2051–2059.PubMedCrossRefGoogle Scholar
  12. 12.
    Unger, B., Kemp, J. S., Wilkins, D., Psara, R., Ledbetter, T., Graham, M., Case, M., & Thach, B. T. (2003). Racial disparity and modifiable risk factors among infants dying suddenly and unexpectedly. Pediatrics, 111, E127–131.PubMedCrossRefGoogle Scholar
  13. 13.
    Colson, E. R., Levenson, S., Rybin, D., Calianos, C., Margolis, A., Colton, T., Lister, G., & Corwin, M. J. (2006). Barriers to following the supine sleep recommendation among mothers at four centers for the Women, Infants, and Children program. Pediatrics, 118, e243–250.PubMedCrossRefGoogle Scholar
  14. 14.
    Centers for Disease Control, Prevention. (1998). Assessment of Infant Sleeping Position—Selected States, 1996. MMWR. Morbidity and Mortality Weekly Report, 47, 873–877.Google Scholar
  15. 15.
    Willinger, M., Hoffman, H., Wu, K. T., et al. (1998). Factors associated with the transition to nonprone sleep positions of infants in the United States: the National Infant Sleep Position Study. JAMA, 280, 329–335.PubMedCrossRefGoogle Scholar
  16. 16.
    Moon, R. Y., & Omron, R. (2002). Determinants of infant sleep position in an urban population. Clinical Pediatrics (Phila), 41, 569–573.CrossRefGoogle Scholar
  17. 17.
    Moon, R. Y., Oden, R. P., & Grady, K. C. (2004). Back to sleep: an educational intervention with women, infants, and children program clients. Pediatrics, 113, 542–547.PubMedCrossRefGoogle Scholar
  18. 18.
    Willinger, M., Ko, C., Hoffman, H. J., Kessler, R. C., & Corwin, MJ. (2000). Factors associated with caregivers’ choice of infant sleep position, 1994–1998: The National Infant Sleep Position Study. JAMA, 283, 2135–2142.PubMedCrossRefGoogle Scholar
  19. 19.
    Ostfeld, B. M., Esposito, L., Straw, D., Burgos, J., & Hegyi, T. (2005). An inner-city school-based program to promote early awareness of risk factors for sudden infant death syndrome. Journal of Adolescent Medicine and Health, 37, 339–341.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Sarah Kye Price
    • 1
    • 5
  • Pamela Gardner
    • 2
  • Laura Hillman
    • 3
    • 5
  • Karen Schenk
    • 4
  • Carrie Warren
    • 5
  1. 1.School of Social WorkVirginia Commonwealth UniversityRichmondUSA
  2. 2.Truman State UniversityKirksvilleUSA
  3. 3.University of Missouri ColumbiaColumbiaUSA
  4. 4.Missouri Department of Health and Senior ServicesJefferson CityUSA
  5. 5.SIDS Resources, IncSt. LouisUSA

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