Background: Nurses have been noted to model unsafe sleep practices for the newborn in the hospital, despite having been extensively trained. Parents report they repeat this behavior at home. There is a reluctance of nurses to comply, notwithstanding implementation of Back to Sleep programs and documentation of parents being taught safe sleep practices, causing a plateau in the reduction sudden infant death syndrome (SIDS).

Methods: Systematic review of literature from CINHAL, Indiana State University Library, Google Scholar, and PubMed from last five years.

Results: Nurses were found to agree with many guidelines. Personal bias, or habit influenced poor implementation. Although provided with the knowledge, infants were continually placed in unsafe sleep positions, resulting in an inconsistency from knowledge to practice by nurses.

Discussion: Every nurse must model a consistent safe sleep message at every bedside interaction throughout the hospital stay. Interventions could include nurse re-education with mandatory declaration of education, and a Nurse Champion to follow up on unsafe sleep observations. Education should resolve the perceived risk of aspiration for supine positioning by nurses, the primary reason for non-compliance. Under educated parents use sleep positions modeled by nurses. Nurses must be educated that modeling unsafe sleep behaviors, such as using rolled blankets, bulb syringes to support side lying, or propping the bassinet up in the crib cannot be used in the hospital. Non-supine positioning should be utilized only when medically indicated, and with clear education for parents.