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Sudden unexpected infant death (SUID) is a leading cause of infant mortality in the United States. Hospitals have implemented infant safe sleep programs with varying measures and degrees of success, but few have demonstrated improvements in hospital-based and home safe sleep practices with nurse subject matter experts (SMEs) and community SUID prevention campaigns.
This project evaluated the impact of a state-wide, evidence-based infant safe sleep program for birthing hospitals using nurse SMEs and a community awareness campaign on nurse knowledge, safe sleep environments, and trends in infant sleep-related deaths.
Between 2016 and 2021, a pre- and post-test quality improvement intervention-based design was used to enroll hospitals and train and embed SMEs to educate peers, conduct practice surveillance and audits, and address practice deviations. A website housed comprehensive resources, and a large-scale community-based social and print media campaign on safe sleep practices occurred. Nurse and practice data from 12 hospitals that fully implemented the program were compared pre- and post-implementation. State-wide survey data for key safe sleep indicators reported by parents were compared from our 12 birthing hospitals to other facilities.
Of trained nurses (N = 902), 83.4% reported making substantial or exceptional progress in being proactive in surveillance of safe sleep environments. Pre- and post-implementation environmental audits showed a significantly higher proportion of infants in safe sleep positions post-implementation (94.3%) than pre-implementation (89.6%) (p = 0.001). Statewide survey data from birth parents discharged from our program hospitals significantly outperformed those discharged from other state facilities. Multi-media campaigns resulted in over 1.4 million impressions on our website. Sleep-related deaths for infants born at four program hospitals dropped 16.1% from 31 in 2018 to 26 in 2021.
A safe sleep program improved hospital-based nurses' knowledge and practice and birth parent's knowledge and behaviors, and it was associated with a decrease in infant sleep-related deaths.
The diverse cultural landscape of Europe underscores the importance of culturally safe healthcare. There is a necessity to assess cultural competence among European nursing faculty to provide an international perspective on cultural competence.
A descriptive, cross-sectional study.
An assessment of cultural competencies was conducted using the Cultural Competence Assessment scale, either in its original language (English) or in its translated and validated versions in Spanish, Italian, Portuguese, and Turkish. An online questionnaire was used to collect data.
The study was conducted in 71 higher institutions, distributed across 17 countries through a consecutive sample of 1364 nursing faculty.
The ethical principles of biomedical research were respected during the study, and the confidentiality of the data was guaranteed.
The mean level of cultural competence of the European nursing faculty was at the level of ‘good’. They showed greater cultural awareness and sensitivity than cultural competence behaviors. Significant associations were found between cultural competence level and the language of the questionnaire, level of education, having a nursing degree, leisure stays abroad, having friends from other countries or cultures, and international experiences abroad and at home. The better levels of cultural competence were found in profiles with the categories of: women with a Nursing Degree, a higher level of education, and with an ERASMUS+ stay experience.
This study offers an international overview of the cultural competence of nursing faculty. While the overall level of cultural competence was good, there is a need to reinforce the behaviors and factors that influence it.
To investigate clients' perspectives about outcomes of a telehealth residential unit (RU) program for families experiencing complex early parenting issues, and to explore facilitators and barriers to positive client outcomes.
Qualitative study using semi-structured interviews.
Semi-structured interviews were conducted with mothers (n = 18) admitted to a telehealth RU program. Interview transcripts were analysed using thematic analysis.
Mothers reported short-term improvements in their child's presenting issues (e.g. feeding to sleep, night-time waking, co-sleeping), increased confidence and increased partner involvement. According to participants, program outcomes were facilitated by a positive parent–clinician relationship, the accessibility of clinicians and being able to take part in the program from their own home. Barriers included difficulties with technical equipment and connecting with the clinician overnight, and challenges with implementing strategies in the longer term.
This nurse-led telehealth program was viewed positively by parents and the study identified a number of areas for improvement.
Telehealth early parenting programs provide an important way for parents to receive support with early child sleep, settling and feeding issues. Clinicians working in this area should focus on the development of positive parent–nurse relationships, enhancing communication and availability for parents during overnight periods and supporting parents to develop early parenting skills that will be applicable across the early childhood period.
The study is the first to address client experiences of a telehealth RU program. Facilitators and barriers identified will inform service improvements to the program going forward, and similar telehealth programs for families; to ensure benefits and service outcomes are maximised for parents for such a crucial service.
The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative research were followed.
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