Sleeping Safe and Sound: A Multidisciplinary Hospital-wide Infant Safe Sleep Quality Improvement Initiative.

Background: Promoting safe sleep to decrease sudden unexpected infant death is challenging in the hospital setting.

Objective: Concern for adherence to safe sleep practice across inpatient units at a large pediatric hospital.

Methods: Used quality improvement methodologies to promote safe sleep across all units. Methods: Development of a multidisciplinary expert group, hospital-wide guidelines, targeted interventions, and bedside audits to track progress.

Results: Adherence to safe sleep practices improved from 9% to 53%. Objects in the crib were a major barrier to maintaining a safe sleep environment. Safe sleep practices were less likely to be observed in infants with increased medical complexity (p = .027).

Conclusions: Quality improvement methodology improved adherence to infant safe sleep guidelines across multiple units. Medically complex infants continue to be a challenge to safe sleep. Therefore, ongoing education for staff and further research into best practices for the most complex infant populations are necessary.