Promoting safe infant sleep: The creation and appraisal of a practice guideline for nurses
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Background: Every day in America, healthy infants are dying from sudden infant death syndrome (SIDS) and other sleep-related deaths. Once a terrifying mystery, these deaths, also called sudden unexpected infant death (SUID), are now considered preventable (American Academy of Pediatrics [AAP], 2016). SUID rates in the United States have remained stagnant and unacceptably high since the late 1990’s despite known modifiable risk factors (Centers for Disease Control and Prevention [CDC], 2017). These rates are higher than most other developed nations (MacDorman, Matthews, Mohangoo, & Zeitlin, 2014). Although prevention strategies are evidence-based and generally known and understood by nurses, studies have shown inconsistent, incorrect, or incomplete education being provided to parents and caregivers around the time of birth (Eisenberg, et al., 2015; Gaydos et al., 2015).
Purpose: In the fall of 2015 the Association of Women’s health, Obstetrics, and Neonatal Nurses (AWHONN) asked the author to write a practice guideline on the topic of safe infant sleep. The purpose of this project was to develop an evidence-based practice guideline for perinatal nurses and leaders. As part of the guideline development, and to establish content validity, a formal appraisal of the guideline by perinatal nurse leaders was conducted using the AGREE II (Appraisal of Guidelines for Research and Evaluation) instrument (AGREE Enterprise, n.d.)
Approach: The appraisal project was a two-phase, non-experimental, descriptive, mixed-methods design using an online survey approach. A convenience sample of perinatal nurse- leaders from a variety of settings was sought. Descriptive statistics were used to describe the quantitative results and qualitative data are reported verbatim due to the small number of comments returned.
Results: Twenty six nurse-leader participants were invited with 15 completing the phase-one survey (57.7%), and 10 completing both phase-one and two (38.5% overall response rate). One hundred percent of the participants rated the guideline as either the “highest possible” or “high quality.” All participants recommended the guideline for use, and 90% (n=9) reported having taken, or planned to take action, since reading the practice guideline. Qualitative data was generally positive with three specific suggestions for changes provided.
Conclusions: This practice guideline has the potential to help individual nurses improve their safe sleep knowledge, practice, and teaching strategies, as well as to help perinatal nurse-leaders conduct large scale safe sleep quality improvement projects.
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