1. Creating a Comprehensive Safe Sleep Program
Webinar 3: Gaining champions and educating staff
Sponsored by a grant from the CJ Foundation for SIDS

2. Your hosts Jason Jarzembowski, MD, PhD Abby Collier, MS
Chair, Safe Sleep Initiative, Children’s Hospital of Wisconsin
Interim Medical Director, Pathology and Laboratory Medicine, Children's Hospital of Wisconsin
Interim Chief (Pediatric Pathology) and Associate Professor, Department of Pathology, Medical College of Wisconsin
Abby Collier, MS
Injury Prevention and Death Review Manager, Children’s Health Alliance of Wisconsin

3. Last time…
A uniform, comprehensive policy is the best way to ensure the safety of sleeping infants
The best way to create such a policy is a multidisciplinary effort using the collaborative efforts of nurses, physicians, other caregivers, educators, public relations specialists, and other experts
Education is the key to success
Explain policy & rationale to parents and caregivers to promote short- and long-term compliance.
Reinforce a single safe sleep message using different people, different media, and different times.

4. This time…
Gaining champions
Educating staff

5. CHAMPIONS

6. Need for Champions Diversity of approaches, opinions, and ideas
Expertise in various areas, for example:
Nursing – “in the trenches,” have to live with and by the policy
Neonatologist – medical indications for exceptions
Lactation consultants – safe sleep while encouraging breast- feeding
Risk Management – how to enforce policy amongst hospital staff and parents/guardian/visitors
Advocates with different people and in departments
No one person in the organization can do this alone

7. Who are your champions? Nurses Physicians
Physical / occupational therapists
Educational services
Public relations and community outreach
Risk management
Patient/family liaisons
Researchers
Administrators
Other staff

8. Where are your champions?
Labor & Delivery
NICU
Other inpatient units?
Emergency department
PT/OT
Outpatient clinics
OB, pediatrics, family med
Administration

9. What will your champions do?
Bring ideas and perspective to the table
Provide “hands on” experience and practical advice
Help get the work done
Promote values and attitude in different areas
Spread knowledge and serve as resource

10. The best way to promote safe sleep
Role-modeling!

11. Role modeling Your champions are role models for your staff
Your staff are role models for each other, and for families
Therefore, staff must know, understand, and model safe sleep at all times!

12. EDUCATING STAFF

13. Education Staff compliance with the policy was poor.
Recognition of the magnitude of the practice change was critical.
Audience for the change implementation is broad.

14. Identifying Messages What are the messages?
What are our measurable results?
What are the crucial moments and vital behaviors?
Are they evidence-based?
Are they clear, keeping in mind plain language and health literacy strategies?
What are our best tools to use with staff and families?

15. Framework for Change Influencer model
Provided the framework to make effective change.
Evidence based approach to making sustainable change.
Previous success with hand-washing campaign.

16. Influencer model - Measurable Results
Goals
Success
Admission screening completed 100% with consults clearly charted.
Compliance with safe sleep environment in- hospital stay = 100% by December.
Discharge review of teaching = 100%.

17. Influencer model – Crucial Moments
Admission/initial encounter screening
Leaving a room after caring for a baby
Observing a family member sleeping with an infant
Observing a co-worker needing to change environment for safe sleep
Follow-up with family not following in hospital safe sleep practice
Discharge of infant home

18. Influencer model – Vital Behaviors
Screening on admission
Anticipatory discussion related to safe sleep in hospital on admission
Check that infant is in safe sleep environment after each interaction
Review of ABCs with family at least once during hospital stay

19. Six sources

20. How are we influencing?
Continue educating and reminding staff with updates, posters, displays, web-casts, grand rounds.
Include it in education updates and courses.
Available resources for questions.
Focus on common deficiencies found in audits.
Students and faculty have helped gather data.
One message, many people, many ways, many times.
Enlist a village of support!

21. Surveys
Before rolling out educational module, administered a short pre-test via SurveyMonkey.
Most staff had good knowledge of safe sleep practices, but wanted help in approaching families about it.
Room for improvement with what is ok in the crib and safest position to prevent choking.
Needed clear information to feel confident in their knowledge and resources when talking to families.

22. Created Online Module
A 30 min. interactive module through our online platform was created. Objectives were:
Define safe sleep, SIDS, and the scope of the problem
Share safe sleep practice and the hospital policy for infant safe sleep
Identify critical safe sleep messages and opportunities to make a difference for babies and their families
Identify barriers and challenging situations with safe sleep
Locate resources

23. Online Module
Required of all CHW staff if they have any interaction with babies or parents.
A broad audience needed education:
In-patient, ambulatory specialty clinics and primary care.
Community based social services agency, community based managed care, school nurses and community education.
Abbreviated education for volunteers.
Recommended for CHW physicians, residents/fellows, and others.
To date, over 1500 people have completed the training!

24. Infant Safe Sleep: Making It a Reality

25. Internal PR Campaign
Safe sleep clings in all CHW patient rooms and CMG clinic rooms
Ads on hallway monitors and in elevators
Safety screen saver
Safe sleep website
Updates in newsletters

26. Initial Audits
Random inspections of infant sleep environments throughout hospital.
Initial audits (pre- and early- education) showed poor compliance (5-50%).
Supplies (wipes, diapers) in crib
Extra linens in crib
Improper use of developmental / positioning devices

27. Recent Audits

28. Take-Home Messages
We must teach and model the basics of safe sleep – Alone, Back, Crib.
The best way to share this message is having multiple people saying and doing the same thing multiple times.
We need to help each other keep our babies safe – reminders, incident reports, double checks.
Administrative sponsorship and a steering committee is critical.
Safe sleep will help Wisconsin’s kids be the healthiest in the nation!

29. Next Webinar Questions? Comments? Webinar 4: ABC’s for families
Wednesday, May 6, noon CST
Questions? Comments?