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Infant Safe Sleep Baby Education Program

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Infant Safe Sleep Baby Education Program INFANT SAFE SLEEP BABY EDUCATION PROGRAM In collaboration with 1 Objectives • Background on Safe Sleep Baby Campaign in Sacramento • Define infant sleep-related deaths terms • Knowledge of UC Davis Children’s Hospital P & P 4124 • Understand the AAP’s 2016 recommendations for infant safe sleep, including Risk Factors • Understand the 6 Steps to Safe Sleep Baby 2 Fast Facts • Every other week in Sacramento County, a baby dies while sleeping • A Significant Number of these babies are African American • Nearly all of them were found in unsafe sleep environments • Infant Sleep-Related Deaths are PREVENTABLE 3 Cause of Death: Co-sleeping, Infant Bed Alexa La’Ray Died at 4 days old Died at 6 weeks old 4 Risk Factors1 • Sleeping in a non-infant bed • Sleeping with others (adults and other children) • Sleeping with objects around baby, such as pillows, blankets, bumpers, stuffed animals, etc. • Sleeping in prone or side position 1 Task Force on Sudden Infant Death Syndrome, SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment. Pediatrics 2011;128e 1341-67 5 CHILDChild DEATH Death REVIEW Review TEAM Team DATA Data INFANT SLEEP-RELATED DEATHS Infant Sleep-Related Deaths • Every other week in Sacramento County a baby died while sleeping Cause of Death, 2013-2014 # of Deaths Infant Sleep-Related Deaths (incl. SIDS, SUIDS & 11 Undetermined) Drowning 4 CAN Homicide 3 Motor Vehicle Crashes 3 • Nearly all babies are found in unsafe sleep conditions • Leading cause of death for babies one month to one year of age – (~90% within first six months) • Occur in all socio-economic, racial and ethnic groups • A significant number of them are African American. 6 Unsafe Sleep Conditions for Sacramento County 100% of all sleep-related deaths of Sacramento babies had at least one known unsafe sleep condition in 2016 CDRT data (11 Infant Sleep related deaths, 3 African American) 7 7 Established Unsafe Sleep Conditions American Academy of Pediatrics and Safe to Sleep National Education Campaign • Soft sleep surface • Sleep position • adult bed, couch or pillow • on stomach or side • Co-sleeping • Overheating • Extra items in the crib: loose • Environmental tobacco smoke bedding, toys 8 8 Infant Sleep-Related Deaths, 2004-2012 • 92% of infant sleep-related deaths occur among children six months old or younger 2 • More infant sleep-related deaths occur during the child’s second month than during any other month 2 ISR Deaths by Age Sacramento County Resident Children 2004-2012, All Races (n=156) 25% 20% 15% 10% 5% 0% 0 1 2 3 4 5 6 7 8 9 10 11 9 Infant Sleep-Related Deaths, 2004-2012: Unsafe Infant Sleep Conditions • 90% of babies who died from an ISRD were found in one or more unsafe sleep environments. • An infant with a history of CPS referrals is 2.4 times more likely to suffer an ISR death than an infant without any CPS referrals. % All Races # All Races Unsafe Infant Sleep Condition (n=156) (n=156) Non-Infant Bed 78% 121 No Crib in Home 64% 99 Co-Sleeping 55% 85 Prone or Side Sleeping Position 46% 71 10 Clinicians Are Influential! • Survey of parents/caregivers/grandparents showed that DOCTORS, RNs AND OTHER HOSPITAL STAFF ARE TRUSTED SOURCES • Repetition of message is KEY • Those surveyed indicated the video needs to emphasize CONSEQUENCES of unsafe sleep practices Families said: “Don’t just give a handout or video to take home. You need to talk about it and show the video.” 11 How YOU can make a difference Perinatal/NICU RNs, Social Workers, Lactation Consultants: • Review the American Academy of Pediatrics (AAP) recommendations and the CNE curriculum (available in the Safe Sleep Baby Program resource binder located on your unit) • Educate parents about the “Safe Sleep Baby” principles as part of education throughout the hospital stay and with discharge education • Model infant safe sleep practices in the hospital • Ask screening questions about the type of sleeping arrangements planned for the newborn infant(s) and document in EMR • “How do you plan to sleep your baby at home?” • Families without a crib can receive a FREE portable crib. These cribs are funded by UC Davis Children’s Hospital and/or another source. 12 2011 AAP Recommendations Expanded from “Back to Sleep” to “Safe to Sleep” Level A Recommendations • Back to sleep for every sleep • Use a firm crib mattress covered by a tight-fitting sheet • Room-sharing without bed-sharing reduces risk by as much as 50% • Keep soft objects and loose bedding out of the crib • Breastfeeding is recommended • Avoid overheating • Avoid smoke exposure • Avoid alcohol and illicit drug use 13 Inpatient Workflow (Birth to 1 year) 1. Ensure parents view the Safe Sleep Baby video on TIGR 883 2. Give parents the Safe Sleep Baby brochure and review the 6 steps to safe sleep with parents 3. Answer any questions parents may have (Review Q & A for Health Care Providers in the Safe Sleep Baby educational binder) 4. Assess if parent has a safe sleep environment for their infant(s) “How do you plan to sleep your baby at home?” 5. Document education and assessment (outlined later in this presentation) 14 Educational Materials • RN/Social Worker Materials • Environment materials Safe Sleep Baby Brochure Safe Sleep Baby Poster and Crib Card Safe Sleep Baby Brochure and Video (TIGR) # 883 15 Key Teaching Points for Families of Newborns 16 Step 1 to Safe Sleep Baby Sleep me Alone ❖ Put your baby to sleep ALONE in his/her crib or bassinet. ❖ Do not sleep with your baby ❖ Do not let other children or adults sleep with your baby 17 Step 2 to Safe Sleep Baby Sleep me on my BACK ❖ Sleep your baby on his/her BACK. ❖ Doctors know “Sleep on Back” will NOT increase the risk of your baby choking. 18 Step 3 to Safe Sleep Baby Sleep me in a CRIB ❖ Cribs and bassinets with a firm mattress and fitted sheets are the safest places for your baby to sleep. ❖ Use your crib or bassinet for all naps and at night. ❖ Return your baby to his or her crib after feeding or soothing ❖ Do not place baby to sleep in an adult bed, couch, recliner, car seat, infant carrier or swing 19 Remember ABC for the first 3 points! 20 Step 4 to Safe Sleep Baby Nothing in my Sleep Area ❖ No pillows, blankets or bumpers ❖ No toys, stuffed animals or other soft things 21 Step 5 to Safe Sleep Baby Do not overdress me ❖ Do not overdress baby when sleeping ❖ Typically, if you are comfortable, your baby is comfortable ❖ Sleep sacks are safe ways to keep baby warm during cold weather 22 Step 6 to Safe Sleep Baby No smoking anything around me Put your baby’s safety first 23 Possible Patient Questions Q: Is it okay to co-sleep? Answer: Babies suffocate on soft surfaces like an adult bed. Babies are more likely to suffocate when they sleep with an adult in an adult bed or on a couch. In Sacramento County, nearly 80% of all babies (90% of African American babies) who died from an infant sleep-related death were NOT sleeping in a crib, bassinet or portable crib. 24 Q: But I’m breastfeeding and it’s easier for me to sleep with my baby Answer: Half of the babies who died while sleeping were co-sleeping. Have the crib or bassinet right next to your bed so that you can have easy access. 25 Q: My mom said that she slept with me and all my siblings! Answer: You were lucky. Not every baby that sleeps with their parents dies, but some do. Half of the babies who died while sleeping were co-sleeping. Your baby can be close to you by putting the crib or bassinet right next to your bed. 26 Key Question to Ask Patient This question MUST be asked of every family: “Where do you plan to sleep your baby when you get home?” All Parents/caregivers should watch the educational video whether they do or do not have a crib. If they have a crib, reinforce teaching points and document assessment and education provided. 27 If patient does not have a crib… • Safe Sleep Baby video must be watched • Obtain referral form from Safe Sleep Baby resource binder on your unit and retrieve a crib • Complete: • Referral form and Infant Portable Crib Agreement form • Fax and leave copies in binder for processing by designated staff • Scan original paperwork into infant’s Medical Record • Advise patient that someone will follow up with them in 2-3 weeks (not from our staff, but someone from our partner agency) • Fill out crib log sheet in the Safe Sleep Baby resource binder 28 Documentation • Document parent/caregiver teaching in Education navigator under: • Safe Sleep education • Infant sleep environment must be documented every shift • Utilize either the dot phrase relevant to your unit OR place a focus note documenting safe sleep principles discussed and the infant’s sleep environment at home • Know tools and documentation – refer to policy for unit specifics and resource binder located on your unit • Contact unit champion for additional assistance 29 Reminders: • Modeling Safe Sleep by staff in the hospital • Your actions will strongly influence our patients and families. Be certain to keep bassinets free of toys and extra blankets • Proper documentation in the EMR and completion of referral form is pivotal to adequately monitor crib distributions • Remember, distribution of a crib is to the discretion of the primary RN, based on whether or not the family states they have access to a crib 30 Questions? Please let the managers or Infant Safe Sleeping Champions know of any questions you have about this process or ideas for improvement.
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