Thank you for accessing our site for information on how to implement a hospital-based infant sleep safety program. We have tried to make the site comprehensive and have included all the documents that we use in our program. The program was established in 2008 and we have research that supports its usefulness for educating both staff and new families. The following paragraphs will outline how each of the documents is used. Feel free to make use of any or all of tools in our package and do not hesitate to contact us with any questions, comments, or constructive criticisms. We are always looking for ways to improve and expand this program. We want to make this program the best it can be because we all have the same goal: to make babies as safe as possible in their sleep environment and eliminate as many of sudden and unexpected deaths as possible.
ABC Brochure English and Spanish– A Cribs for Kids brochure that you can download and give to parents or caregivers.
Acknowledgement Form English and Spanish– A form signed by parents/caregivers to the hospital which acknowledges they have received and understand the importance of safe sleep.
Audit Tool Form– Form used for conducting auditing in the NICU, PICU, PEDs and nursery.
Community Initiative Letter to Hospitals– A sample letter to hospitals about the program.
Community Initiative Letter to Providers– A sample letter to share with other healthcare providers in your community introducing them to your hospital’s safe sleep program.
Hospital Certification Step by Step Guide– Provides an overview of the entire safe sleep initiative.
Hospital Initiative Product Order Form– A fillable form to order safe sleep products.
Hospital Policy– A policy for infant sleep safety practices.
Infant Safe Sleep Graduation Certificate– Downloadable certificate that can be given to the parent or caregiver once they receive their infant safe sleep education.
Infant Safe Sleep Screening– A form that can be completed by the parent or caregiver to gather further information.
NICU Graduation Certificate – A downloadable certificate that can be given to the parent or caregiver once their infant has graduated to the safe sleeping environment.
Non-Compliance Waiver on Infant Safe Sleep English and Spanish– A form that acknowledges that parents have been educated on infant safe sleep but do not choose to not follow the safe sleep practices while in the hospital.
Nursing Education– Module used for training nursing staff.
Organizational Chart– A chart to help implement a hospital-based infant sleep safety program.
PDSA Cycle Form– A “Plan Do Study Act” form used for conducting audits.
Safe Sleep Educational Flip Chart– An educational tool with talking points for training on infant safe sleep.
Safe Sleep Post Test and Key– Safe Sleep QA for competency
Verbiage for Website- Certifiedgold hospitals must include safe sleep on their websites and this document provides appropriate wording.
Use the links below to download your certification materials.