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Trainer's Guide

Newborn Nursery Personnel

Newborn Nursery Personnel

Risk Reduction Training for Newborn Nursery Personnel

Newborn nursery staff and nurses perform an essential service in our society. New parents often look to this staff to guide them in infant health care and practices that will provide the best start in life for their new baby. The newborn nursery staff skills update PowerPoint presentation addresses not only risk reduction messages but the importance and opportunities for patient education and modeling best practices to patients and clients.

Research shows that while most nurses are aware of the AAP’s back sleep recommendation, they may not actually follow these recommendations. A 1999 study showed that while 97 percent of the MCH nurses surveyed reported awareness of the recommendation, only 67 percent agreed. The majority of the nurses who disagreed cited “experience” or “the potential adverse consequences of the supine position” as their reasons for disregarding the recommendations.4 Studies have also found that newborn nursery staff do not uniformly recommend the supine position to families.5,6

A California study conducted at eight perinatal hospitals found that only 34 percent of the nursery staff reported consistently encouraging mothers to practice supine infant sleep positioning.7 Another study found that nurses with fewer years of experience are more likely to encourage parents to use the back-only position. Nurses with more years of experience do not use or recommend this position primarily because they believe infants do not sleep well in that position.8

Physicians, neonatal intensive care nurses and other medical professionals remain uncomfortable recommending non-prone sleeping for VLBW infants despite the AAP’s recommendation and the physiological data to support it.9 Nurses in both well-baby units and NICUs report skepticism of the BTS message because of fear of aspiration. However, it is clear that there has been no increase in the number of infants who die of aspiration from being placed in the supine position.10

In addition, nurses do not always realize their impact on parents’ decision regarding sleep position. Modeling suggested behaviors, such as back sleeping, can be a powerful educational tool in conjunction with written educational materials.

Many hospitals offer in-service continuing education and human resources departments will often have staff dedicated to in-service seminars. A large barrier and limitation is staff time. Hospitals and nurses continue to experience a shortage of staff and time. Therefore, it will be important to look for ways to work with hospital’s administration to make training a priority for staff and within the constraints of various schedules.