immediately after the administration of Questionnaire II. A 19-item investigator-designed questionnaire was adapted using the "Safe Sleep Survey" developed by Indiana Perinatal Network. Guidelines to Sleeping Safe with Infants: Adapted from: Maximizing the chances of Safe Infant Sleep in the Solitary and Cosleeping (Specifically, Bed-sharing) Contexts, by James J. McKenna, Ph.D. rib Pack-n-Play ed with an adult ed with children Stroller assinet Other _____ Email completed forms to: cribsforkids@nassaucountyny.gov or fax to: (516)227-9501 �q� �X�"*�,T��r��'�ځ�sG I1�P��Dw;r��eo׺n �O�W B��A�@J��`���X7�C��4dȄ?�e V�vM륧ӥ����P{X2��{}1�D�]�*��E��r J *�\���bI;��/"��B�&��xq�3���g�%/�jyږGLv�sFc��|����������������[� �݄x�}i�� True False The safest place for babies to sleep is in the same room with parents. y� �!S@v��Z�HQr�@_$a�/��UD%Φ���/0��l�Z��qA�1��*�,�5j��ģ9����sRf�Q(�>����6l�5;h��E[l;Ek�A�Ů{�:,97�����Kq�(N� y���R�� The Baby Sleep Safety Quiz Your baby loves to sleep, so it’s important to establish safe snoozing practices from day one. The template for Questionnaire II is available for download on the . 2. Consortium for Children’s website. The Newborn Sleep Safety Survey is a reliable tool to identify risk of SIDS in the sleep environment. %PDF-1.5 %���� And the sleep questionnaire takes a fair amount of time for the clinician to review. Safe to Sleep Crib Audit Tool If the baby is awake, please stop and return to complete evaluation when asleep. Reporting. Sleep Disorders Risk Questionnaire. * Never place your baby to sleep on pillows, quilts, sheepskins, and other soft surfaces. A brief description of each questionnaire is presented, as well as their original and related references. çך–™3x(jÞJªŽ^Yø…í¶_áF¯KñÊånŒ:—Ðѧx8£¶ÛÍj[÷~îI½W»õþ‚a0&%­þM5EWº®îVí¶êbðR2jғç菮^¯¶Ûíæ0]Ì蓃ˆ8ºIOžctÍ?_÷›Õú€£qXg.x1gÍu]­úŠxÁÍX²;xKæ¡ \¸B,`)ÏaÐtÅ¡À¶nv«ªï …¡ä€„§ÚNF‰ö(aaf®—²ë#MŽóB¾oѱúÚD°z#‡(¿Cc!—² Sleep environment habitS Typical sleep position(s) q back q side q stomach q head elevated q in a chair q I sleep alone. Safe Sleep Program Evaluation Questionnaire Author: labuser Last modified by: Wood County Created Date: 1/22/2010 1:55:00 PM Company: Medical College of Wisconsin Other titles: Safe Sleep Program Evaluation Questionnaire True False After traveling, babies can stay sleeping in their car seat when at home. Community Baby Shower for Safe Sleep Safe Sleep for Babies Survey What are the ABCs of safe sleep? Yes No If yes, what have you learned? Any surface that does not stay flat with the infant on it, increases the risk of the baby re-breathing exhaled air or suffocating. Safe Cosleeping Guidelines. Obstructive Sleep Apnea has been linked to heart disease, COPD, stroke, diabetes and cancer and its effects range from daytime sleepiness, depression, relationship issues and dementia. Yes No If yes, when the baby sleeps away from your home, where does the baby sleep? Why bumpers, blankets and toys are unsafe. Get Information and Materials. •Crib Audit - Preferred baseline of at least 20 audits or 10%, whichever is greater. Using the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and other programs that serve mothers and babies to deliver culturally appropriate messaging about safe sleep for babies. Did anyone ever talk to you about the safest place to put your baby down to sleep? n��i~J�{F��#�� r��o endstream endobj 185 0 obj <>stream 2. SRN web-education committee members identified commonly used and validated questionnaires that are relevant to research and clinical practice of both adult and pediatric Sleep Medicine. Make sure there is a clear discrepancy in the quality of the end of the routine: high quality routine (e.g., choice Contact us → Sleep survey questions are survey questions asked by medical professionals such as doctors, psychiatrists or mental health professionals. The Safe to Sleep® campaign, formerly known as the Back to Sleep campaign, focuses on actions you and others can take to help your baby sleep safely and to reduce your baby's risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related causes of infant death. �}��ƌ&�E�J�?f���Z�1d�-�V�)�2笭����ZW�6���"!��0���3�S�����j7ݢ�Ճr���. 3. q I share a bed with someone. During this pregnancy has anyone talked to you about “ack to Sleep”, A ’s of Safe Sleep or SIDS? It’s a recommendation that has largely contributed to an 85 per cent reduction in … Does your baby sleep away from home? ��ފ�� h�\�]k�0��ʁ]T/4ǘuE�Z�k)ջ���!ZB�������r%��p�3�5C�Hf����y�d�������9{*@E㙭 U��Me��d#�*ƈW���g���PB� Please indicate if you have any of the following symptoms and with what frequency such symptoms occur using the numbered scale below: 0 - Rarely/None; 1 - Some of the Time; 2 - Frequently or Part of the Time; 3 - Most of the Time; Sleep Apnea: I am sleepy during the day though I have slept through the night. �6T��$����, �0k=�j�y�����0 ��#� endstream endobj 187 0 obj <>stream ��$�Fh�a]��}gmZr($���0����0�Da(!�$` ���s�`������_��m��݈�;Q3�M����u�xI.Rk����Դ�d6�-����:��-u��qp��Վ�_,\I_��X�v��/���%z?����T�Y�-�U"[�DI��p07~0HQ���+��Z_�v?���8�}#���]xS��3v?w^�Q]�cr������Ë?^jz�}/�ڦ�p#/�Sd�|��i�)� BgJ endstream endobj 184 0 obj <>stream 183 0 obj <>stream If your score is 6 points or higher contact us, or click here for your secure proprietary ARES™ Sleep Screener. What is a Crib Audit? Now research confirms what we have known all along: Advice from health care providers makes a difference in parent and Sleep questionnaires usually combine multiple smaller question sets. 10. _____ _____ _____ 3. sleep measures, and 4) to examine the possibility of using the questionnaire as an Internet resource for parents. Why you should always sleep baby on their back The first of the six safe sleeping recommendations is to sleep baby on their back from birth. Always place your baby on his or her back to sleep—for naps and at night. h���Mk1�"��A���Fn0� ��&�ķ҃��c�eӏ�Q��|h �̾�b���x+�� ��� A sample of 161 parents responded. Take our quiz now to see how sleep … SIDS is the leading cause of death of infants between 1 month and 1 year of age. h�t��n�0�_%7��'�i�P%(UZE{���TZ�:��Abo?��#�X����툈�N����YR��3c���UcO The purpose of this study was to evaluate the effectiveness of the curriculum and train-the-trainer model in changing knowledge, attitudes, and behaviors (reported and observed) in child care providers with regards to sleep position and other elements of a safe sleep environment for infants. The law further specifies that facilities and locations that must participate in the Safe Sleep Education Program and regularly have infants sleeping at them adopt an internal infant safe sleep policy. Baby Safe Sleep Coalition c/o Jewish Family Service of Rochester 441 East Avenue Rochester, NY 14607 Phone: (585) 473-SAFE (7233) QUICK LINKS How big a problem is unsafe sleep? A safe sleep surface has the infant sleeping on a flat firm surface. •Patient safe sleep educational materials provided: yes/no? hތ�oo�0ƿʽGS��lKh�L�4x����x���E�tj2�}{;ݚv-L��Ǿ;���-�!�䍒�%�r�$B֥H�d�&�@Vo>>�����#1����.m���j�w]�>���~8��W������]���rE���\]�� �\]>���M5��V�嗮E��B ͽ��Yw�7�<0���Ҧ}�B>&��$X���BV�q�/b�ǘ�v����+Ir/b79���G�NJ�B��ҧ�Ǖ����\�D��h�1�����?�� �Y�������i8�G���M��}�8�����'��@ς�! A sleep study or polysomnogram is a test that records information about you while you sleep. Each question set has been shown to predict certain sleep conditions. 4975 Bradenton Avenue Dublin, Ohio 43017 Phone: 614.766.0773 Map & Directions. £fÏÑ^EVΡÞÔ«jÓ&ÍqÏtÁ­ÙBBŒ´lJ3ŒÉÎ)Ù4ž•×m³ê&)IÕïs”¦¼a®²`ax‹™£\%26a,£À3JIÃbʹ~æJà9Êu«¯~«½æ2pòAËÐôk4 6$'ŒáU+Haid. Improving safe sleep practices in child-care and hospital settings by training providers. The SAFE training provides practitioners with resources and information to assist in their interviews. The first study was based on clinical and nonclinical control samples. Sleep questionnaires take time for the patient to complete. • How to create a safe sleep environment for your baby. High risk of potential Sleep Apnea. Arch Pediatr Adoles Med 2001;155:1231-7. ��V��%b�2#XI��$n� The surface should maintain its shape when the infant is placed on the surface and does not conform to the infant’s head. This study compared parent responses on the Newborn Sleep Safety Survey and observational assessments (N=72) of infant sleep environments … Share this video to help explain ways to practice safe infant sleep and breastfeeding. ORC 3701.67 establishes an infant safe sleep screening procedure for hospitals and birthing centers. Questions You Should Ask About Your Sleeping Habits. If you're still tired on a solid night of rest, take a look at how you're snoozing. The American Academy of Pediatrics (AAP) recommendations describe the safest environments to protect infants. Help get the message out to the community. l=��P6..�f�m��}�m� Teach your child to be compliant during the day. My bedroom is q comfortable q noisy q too warm q too cold q es Y q No I have pets in the bedroom. Sleep into the Safe to Sleep ® campaign to formally address issues related not only to SIDS, but also to other sleep-related causes of infant death, a safe infant sleep environment, and other infant health issues. 7277 Smith's Mill Road New Albany, Ohio 43054 Phone: 614.775.6177 Map & Directions Also, some States have started their own campaigns. • Place your baby on a firm sleep surface, such as a safety-approved crib mattress, covered by a fitted sheet. Sleep Disorder Questionnaire. Þa“vu¹A¯ŽS%pT̕ì-@=aMþ†¢zÂB~{Jàšº_m{8w.Å:^uÖ»~՚{òí½„f½mVUæ7‡¨Åd$"ÇôÄ|ßõŠÍq¡yñ¥ãëçR}/¤ ¥õîœBS ‚Ÿ ((=xk¬òPÑJoþÕµÑïÜï¿q-|ûk×W-¥B¥UÃ1¥˜¥¤5‹ÆTd™ÙCxÔfÙ+„A£i^Ae#š]#à@Œ«Óøæ.0™&ÖUÕA›~¿½,L®Å4À35 Sleep survey questions can enable the researcher to understand the factors that are affecting the sleep of an individual and analyzing the same can give corrective actions to improve the quality of sleep. L)@��p|3�6�ϣ�Fj�o�Ud+�E h�ܒ�j�@�_e����Z���P �G�r� ��$�G>����^trҞ^�ϕ�/�Y.ۏ�"�zߞ %����TF*�^�����t�M���h�v�b�s�v���B|*�e\�(B���b,�F7��bSz.��f7,ީ�K����U{1��⵫������^>߆}������ޗ( t';� IwN&[�ɱ/h�^M����+X��@�&X ��5���[{�����na,[Q�4�呋O�lW��8�š�ú�=�nw�r9���=(l�C��]��(2��Y�dRlm1�Gږ�\آk������c�/�k&���/�o�����Z�E �RIR+�+l 6���jXu�QT�@j&_� Virginia has partnered with AARP to help grandmothers get the latest information about Safe Sleep and prenatal care issues, and North Carolina has published a Promising Practice paper on Baby’s Easy Safe Sleep Training which focuses on the entire family. Two studies were conducted with the brief infant sleep questionnaire (BISQ). Yes No If yes, please check the boxes where you learned or heard about the information? The back sleep position is the safest, and every sleep time counts. Be sure to capitalize on sleep pressure by sending the child to bed at the beginning of their sleep phase. Read Article. ���,}۠��K�uԸ���d8-��{)���n���җi-���!���W��1H!u�6� F: )������D�O�#��+&T�*�'r�x=������ X�a��غ��JoW�Ke�5�q������� ]p% endstream endobj 186 0 obj <>stream q es Y q No I watch TV in bed prior to sleep. If you answer YES to three or more of these questions, you may have some degree of sleep apnea or another sleep disorder. See these 10 steps to gain compliance. We have information and materials for many audiences, including parents, grandparents, and health care providers. Learn more about how a sleep study works, what it helps diagnose, and how to prepare. 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