Barriers and facilitators to modeling safe sleep practices in the NICU: A qualitative study of nursing & parent perspectives

Alice E Burgess; Stephanie L Bourque; Christina R Fisher; Rebecca Allen; Sunah S Hwang

doi:10.1038/s41372-025-02507-7

Barriers and facilitators to modeling safe sleep practices in the NICU: A qualitative study of nursing & parent perspectives

J Perinatol. 2025 Dec 1. doi: 10.1038/s41372-025-02507-7. Online ahead of print.

Authors

Alice E Burgess¹, Stephanie L Bourque², Christina R Fisher², Rebecca Allen², Sunah S Hwang²

Affiliations

¹ University of Colorado School of Medicine, Aurora, CO, USA. alice.burgess@childrenscolorado.org.
² Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO, USA.

PMID: 41326751
DOI: 10.1038/s41372-025-02507-7

Abstract

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.