Date of Doctor of Nursing Practice Project Completion
Summer 7-29-2026
Faculty Advisor
Deborah McCrea
Abstract
Purpose: This quality improvement (QI) project aimed to increase the reliability of standardized, evidence-based safe sleep education for caregivers of infants aged 0–12 months in an outpatient pediatric cardiology clinic within an academic health system
Background: Sleep-related death is the leading cause of death among infants aged 1-11 months and the third leading cause of infant mortality overall and is closely associated with modifiable unsafe sleep practices. Safe sleep education is delivered inconsistently across settings, particularly during the hospital-to-home transition for infants with complex cardiac disease.
Methodology: A caregiver-completed Safe Sleep Screening Checklist was embedded into clinic workflow. A medical assistant scored the checklist, and a score below the maximum triggered escalation to nurse-provided targeted education. All caregivers received the NIH safe sleep handout. Two Plan-Do-Study-Act cycles refined the screening tool over an eight-week period, and process measures were analyzed with descriptive statistics.
Results: Across 76 completed checklists, safe sleep education and handout provision was documented for 89.5% (68 of 76). Among 31 caregivers who scored below 4 of 4 for one or more unsafe practices, 30 were indicated for escalation. Education was documented for 63% (19 of 30). Most missed escalations occurred because families left or were admitted before nurse education could be delivered.
Implications: A checklist-and-escalation workflow reliably embedded safe sleep education into an outpatient subspecialty clinic. The screening-to-nurse hand-off is the primary target for improvement, and triggering education earlier in the visit may increase reliability.
Keywords
Key words: safe sleep, infant, quality improvement, pediatric cardiology, caregiver education
Recommended Citation
Casey Hrbacek, "Standardizing Safe Sleep Education in an Outpatient Pediatric Cardiology Clinic: A Quality Improvement Initiative" (2026). Doctor of Nursing Practice Final Project Abstract. 224.
https://digitalcommons.library.tmc.edu/dnp_abstract/224