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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 7: Injury Hospitilization

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Strategy. Hospital-Based Multi-Component Safe Sleep Training to Prevent Infant Suffocation

Approach. Conduct safe sleep training for nurses and/or mothers in maternity wards/neonatal intensive care units (NICUs) using educational materials (videos, posters, checklists) + revise hospital policies and practices to align with the American Academy of Pediatrics’ recommendations.

Note: This stragegy is one of a number of evidence-based approaches addressed in NPM 5. Please see a full list of NPM 5: Safe Sleep strategies here.

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Overview. Studies show that hospital-based multi-component safe sleep training programs have positive effects on increasing nurse and/or parent knowledge and utilization of safe sleep practices.1-6

Evidence. Moderate. Hospital-based multi-component safe sleep training programs appear to be effective in increasing awareness and implementation of safe infant sleep practices. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Nurses, caregivers.

Outcome.   Increased knowledge and utilization of safe sleep practices. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.

Examples from the Field. Access descriptions of ESMs for NPM 5: Safe Sleep that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM. You may also want to look at evidence that supports educational programs in other NPM topic areas that can be translated to this specific topic area.

Sample ESMs.Using the approach “Conduct safe sleep training for nurses and/or mothers in maternity wards/NICUs,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

  • Number of hospitals participating in safe sleep training.
  • Number of nurses participating in safe sleep training.
  • Number of hospitals with protocols that align with the American Academy of Pediatrics' Recommendations for Safe Sleep Infant Environment.

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

  • Percent of hospitals participating in safe sleep training.
  • Percent of nurses participating in safe sleep training.
  • Percent of hospitals with protocols that align with the American Academy of Pediatrics' Recommendations for Safe Sleep Infant Environment.

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

  • Number of nurses who showed an increase in knowledge of safe sleep practices after they participated in the training.
  • Number of mothers who showed an increase in knowledge of safe sleep practices after they participated in the training.
  • Number of women who give birth at hospitals with protocols that align with the American Academy of Pediatrics' Recommendations for Safe Sleep Infant Environment that report confidence in applying infant safe sleep practices.

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

  • Percent of nurses who showed an increase in knowledge of safe sleep practices after they participated in the training.
  • Percent of mothers who showed an increase in knowledge of safe sleep practices after they participated in the training.
  • Percent of women who give birth at hospitals with protocols that align with the American Academy of Pediatrics' Recommendations for Safe Sleep Infant Environment that report confidence in applying infant safe sleep practices.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References:

1 Gelfer P, Cameron R, Masters K, Kennedy KA. (2013). Integrating ‘‘back to sleep’’ recommendations into neonatal ICU practice. Pediatrics, 131(4): e1264–e1270.

2 Goodstein MH, Bell T, Krugman SD. (2015). Improving infant sleep safety through a comprehensive hospital-based program. Clinical Pediatrics, 54(3): 212–221.

3 Mason B, Ahlers-Schmidt CR, Schunn C. (2013). Improving safe sleep environments for well newborns in the hospital setting. Clinical Pediatrics, 52(10): 969–975.

4 McMullen SL, Lipke B, LeMura C. (2009). Sudden Infant Death Syndrome prevention: A model program for NICUs. Neonatal Network, 28(1): 7–12.

5  Shaefer SJ, Herman SE, Frank SJ, Adkins M, Terhaar M. (2010). Translating infant safe sleep evidence into nursing practice. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 39(6): 618–626.

6 Voos KC, Terreros A, Larimore P, Leick-Rude MK, Park N. (2015). Implementing safe sleep practices in a neonatal intensive care unit. The Journal of Maternal-Fetal Neonatal Medicine. Doi:10.3109/14767058.2014.964679.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.