Enhancing Nurse Adherence to Infant Safe Sleep Practices: A Quality Improvement Project

Abstract

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to improve nurse adherence to evidence-based infant safe sleep practices in the Neonatal Intensive Care Unit (NICU) at Phoenix Children’s Hospital. Inconsistent modeling of safe sleep behaviors by nurses can lead to mixed messages for families and increase the risk of Sudden Unexpected Infant Death (SUID) after discharge. This project aimed to enhance nurse knowledge, confidence, and adherence to safe sleep guidelines through structured education. Methods: This quality improvement initiative utilized a Plan-Do-Study-Act (PDSA) framework over a 7-day period. An evidence-based infographic was developed and distributed to NICU nurses. Brief, in-person educational sessions were conducted during daily shift huddles to review safe sleep recommendations and encourage consistent bedside practices. Pre- and post-surveys measured changes in nurse knowledge, confidence, and self-reported adherence to safe sleep practices. Participation was voluntary, and no identifiable data were collected. Results: 30 NICU nurses participated in the intervention, resulting in a 17% increase in confidence and full recognition of all ABCDE components of safe sleep. Nurses identified visual aids, clear policies, formal training, and leadership support as key needs, and 100% reported plans to apply safe sleep education in their practice.Conclusions: The use of a brief educational intervention effectively improved nurse confidence and knowledge in providing safe sleep education. Findings support the value of structured teaching and visual tools in promoting consistent and evidence-based safe sleep practices in the NICU.