Macklin Jamie R, Bagwell Gail, Denny Sarah A, Goleman Jane, Lloyd Julia, Reber Kris, Stoverock Linda, McClead Richard E
Division of Hospital Pediatrics, Nationwide Children's Hospital, Columbus, Ohio.
Division of Neonatology, Nationwide Children's Hospital, Columbus, Ohio.
Pediatr Qual Saf. 2020 Oct 23;5(6):e339. doi: 10.1097/pq9.0000000000000339. eCollection 2020 Nov-Dec.
Many hospitalized infants are not observed in an American Academy of Pediatrics-recommended safe sleep environment, which can translate to unsafe sleep practices at home. We implemented this collaborative to reduce our county's sleep-related death rate by improving infant safe sleep practices in the freestanding children's hospital setting and increasing safe sleep screening and education in our clinics and emergency departments (EDs).
Physicians from our institution's primary care clinics, EDs, neonatal intensive care units, and general inpatient units created and led multidisciplinary safe sleep teams. Teams have used standardized data tools to collect information on infant patient ages and sleep position and environment, both in the hospital and at home. Based on audit data, teams have implemented multiple Plan-Do-Study-Act cycles during this collaborative. We have calculated changes in safe sleep practices in the hospital and changes in screening and education on safe sleep behaviors over time.
Our teams have significantly increased compliance with safe sleep practices in the inpatient and neonatal intensive care unit settings ( < 0.01). We have also increased screening and education on appropriate safe sleep behaviors by ED and primary care providers ( < 0.01). Our county's sleep-related death rate has not significantly decreased during the collaborative.
Our collaborative has increased American Academy of Pediatrics-recommended safe sleep practices in our institution, and we decreased sleep-related deaths in our primary care network. We have created stronger ties to our community partners working to decrease infant mortality rates. More efforts will be needed, both within and outside of our institution, to lower our community's sleep-related death rate.
许多住院婴儿并未处于美国儿科学会推荐的安全睡眠环境中，这可能意味着在家中存在不安全的睡眠习惯。我们开展了这项合作，旨在通过在独立儿童医院环境中改善婴儿安全睡眠习惯，并在我们的诊所和急诊科增加安全睡眠筛查与教育，来降低我们县与睡眠相关的死亡率。
我们机构的初级保健诊所、急诊科、新生儿重症监护病房和普通住院病房的医生组建并领导了多学科安全睡眠团队。这些团队使用标准化数据工具收集有关住院和在家婴儿患者年龄、睡眠姿势及环境的信息。基于审核数据，团队在此次合作期间实施了多个计划-执行-研究-行动周期。我们计算了医院内安全睡眠习惯的变化以及随时间推移安全睡眠行为筛查与教育的变化。
我们的团队显著提高了住院部和新生儿重症监护病房环境中安全睡眠习惯的依从性（<0.01）。我们还增加了急诊科和初级保健提供者对适当安全睡眠行为的筛查与教育（<0.01）。在合作期间，我们县与睡眠相关的死亡率并未显著下降。
我们的合作提高了我们机构内美国儿科学会推荐的安全睡眠习惯，并且我们降低了初级保健网络中与睡眠相关的死亡率。我们与致力于降低婴儿死亡率的社区合作伙伴建立了更紧密的联系。需要在我们机构内外做出更多努力，以降低我们社区与睡眠相关的死亡率。
