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

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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.

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Notes

  1. Eligible hospitals defined by Bullock et al. [1]) as those hospitals with more than 3 deliveries per year.

  2. The specific curriculum used for this training is available through the contract agency, listed in the authors’ acknowledgements at the end of the manuscript.

References

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  6. Parmet, S., Lynm, C., & Glass, R. (2002). Sudden infant death syndrome. JAMA, 288, 2772.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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. 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.

    Article  PubMed  CAS  Google Scholar 

  16. Moon, R. Y., & Omron, R. (2002). Determinants of infant sleep position in an urban population. Clinical Pediatrics (Phila), 41, 569–573.

    Article  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  Google Scholar 

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Acknowledgements

Funding for the Back to Sleep Nurses Training Program was provided through the Missouri Department of Health and Senior Services in the form of a one-year sub-contract which was competitively awarded to SIDS Resources, Inc. to design and implement the training curriculum. The training curriculum is available for review and purchase by contacting SIDS Resources, Inc. (1-800-421-3511; www.sidsresources.org).

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Authors and Affiliations

  1. School of Social Work, Virginia Commonwealth University, 1001 W. Franklin St, Richmond, VA, 23284, USA

    Sarah Kye Price

  2. Truman State University, Kirksville, MO, USA

    Pamela Gardner

  3. University of Missouri Columbia, Columbia, MO, USA

    Laura Hillman

  4. Missouri Department of Health and Senior Services, Jefferson City, MO, USA

    Karen Schenk

  5. SIDS Resources, Inc, St. Louis, MO, USA

    Sarah Kye Price, Laura Hillman & Carrie Warren

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  1. Sarah Kye Price
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  2. Pamela Gardner
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  3. Laura Hillman
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  5. Carrie Warren
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Correspondence to Sarah Kye Price.

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Price, S.K., Gardner, P., Hillman, L. et al. Changing Hospital Newborn Nursery Practice: Results from a Statewide “Back to Sleep” Nurses Training Program. Matern Child Health J 12, 363–371 (2008). https://doi.org/10.1007/s10995-007-0243-y

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  • DOI: https://doi.org/10.1007/s10995-007-0243-y

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