Hospitals in pursuit of excellence

KISS (Keep Infants Sleeping Safe)

An unprecedented cluster of infant falls from post-cesarean section mothers' arms sparked the maternal child nurses at Good Samaritan Hospital Medical Center to examine their infant safety strategies. These events represented a call to action related to co-sleeping, and a task force was created to plan an infant fall prevention program. A rigorous search of the literature found virtually nothing published, as infant falls do not appear to be routinely tracked and reported. The task force compiled a list of hypothetical risks for infant falls, which included the preconceived notion that mothers were more apt to drop their infants during the immediate postoperative/delivery period and that narcotic administration would be a contributing factor. All five incidents happened between postoperative day 2 and 3, and there was no link to narcotic administration. What was discovered after a comprehensive review of the medical records was the highest risk for infant falls appeared to be the mother's body mass index greater than 30.