Barriers and Facilitators to Modeling NICU Safe Sleep Practices in the NICU: A Qualitative Study of Nursing & Parent Perspectives

Objective: To identify nursing and parent-perceived barriers and facilitators to adherence to safe sleep practices in a level IV NICU. Study Design: 20 NICU nurses and 10 parents of infants who were hospitalized in a level IV NICU within the past year participated in this qualitative study. Themes from coded interview transcripts were identified utilizing deductive thematic analysis. Results: Barriers and facilitators to safe sleep practices spanned across individual-, unit-, and community-levels. The significance of cultural preferences and traditions, hands-on practice and direct modeling, developmental positioning tools and reflux precautions, inter-team communication and consistency, different learning styles, and caregiver stress associated with NICU stays emerged as key themes. Conclusion: We identified several barriers and facilitators of effective safe sleep modeling in the NICU from both nursing and parent perspectives. These insights will help to inform a collaborative, family-centered, and sustainable approach to integrating safe sleep practices in the NICU.