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The NICU Ensures Safe Sleep One Swaddle at a Time

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Posted January 15, 2019

Patients who receive care in the Women & Babies Hospital Neonatal Intensive Care Unit (NICU) are small in size, but their needs are great. These tiny patients usually spend anywhere between 1 week to 4 months in the NICU. During this time, many parents begin to see the clinical staff as an extension of their own family, while also learning how to care for their new baby.

“Research shows that parents, once at home, will mimic the techniques they saw used by NICU staff, especially when the techniques are implemented each day,” said Margi Bowers, NICU nurse manager.

Newborn. Image credit: Pixnio, CC0 Public Domain

With that research in mind, the team focuses on promoting safety techniques with parents while their baby is still in the NICU.

In 2017, the Pennsylvania Child Death Review Annual Report showed that approximately 3,500 infants in the United States die each year from Sudden Unexpected Infant Death (SUID) and Sudden Infant Death Syndrome (SIDS).

“After reviewing the 2017 report, we asked ourselves how we could make a difference and help reduce the number of SIDS-related deaths,” Bowers added.

In alignment with the American Academy of Pediatrics’ “Safe to Sleep” campaign and sleep environment guidelines, the NICU enhanced current safe-sleep techniques, including more conversation regarding safe-sleep practices and the replacement of traditional receiving blankets with sleep sacks, which first started in January 2018.

“Our goals were to develop consistent messaging among staff and to demonstrate safe-sleep practices so that parents would naturally implement them at home,” said Karen Rausch, NICU RN.

To ensure that all employees understood the department-wide changes, Rausch conducted an educational session during a staff meeting, in addition to a mandatory online training that took place in March.

“We also included ongoing conversations during our daily huddles,” Bowers added. “We used role-playing to help staff feel comfortable explaining safe-sleep procedures to parents and family, and we continue to conduct unannounced bedside audits to guarantee that the new practices are being followed.”

In addition to staff messaging, Rausch developed “care cards” that are placed on each baby’s incubator to explain their sleep mode. “Some babies start off sleeping on their stomach and use special positioning devices. We call this ‘therapeutic positioning,’ ” she said. “However, by the end of their stay, babies are sleeping on their backs in the provided swaddle, which we call ‘safe-sleep mode.’ ”

The visual reminders encourage staff and parents to have an ongoing dialogue about the child’s care and safe-sleep techniques.

Finally, the NICU team adjusted the graduation/discharge process, which includes requiring parents to watch a safe-sleep video produced by the National Institutes for Health prior to discharge.

“Overall, I hear more dialogue between staff and parents because it is woven into our care model. We know we have done our part on educating parents, and we also find joy in sending our little graduates home in a Women & Babies swaddle to celebrate their accomplishments,” said Bowers.

Source: University of Pennsylvania

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