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Discussing Safe Sleep for Babies with Caregivers The Professional Development Series provides supervisors with materials for facilitating learning sessions on “hot topics” with their staff members. The goal of the series is to promote and support effective practice within the agency. This installment of the series is designed to improve practice around safe sleep for babies. Leader’s Guide March 2016

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Page 1: Discussing Safe Sleep for Babies with Caregivers · Sleep for Babies with Caregivers The Professional Development ... Discussing Safe Sleep for Babies with Caregivers March 2016 2

 Discussing Safe Sleep for Babies with Caregivers

The Professional Development Series provides supervisors with materials for facilitating learning sessions on “hot topics” with their staff members. The goal of the series is to promote and support effective practice within the agency. This installment of the series is designed to improve practice around safe sleep for babies.

Leader’s Guide March 2016

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 2

Introduction to Your Leader’s Guide Overview This installment of the Professional Development Series is designed to

help reinforce best practice around safe sleep for babies. Important points related to safe sleep include:

• According to the Georgia Child Fatality Review Panel, Georgia averages 3 children are dying every week in Georgia due to sleep related causes. Educating caregivers and the community about safe sleep environments is an integral part of lowering this rate.

• It is not enough to show the safe sleep video to caregivers. A “conversation” is required in order to help caregivers understand the seriousness of unsafe sleep environments for their baby.

• Case managers must understand and promote the A(lone), B(ack), C(rib) formula to caregivers and community partners.

• Discussing safe sleep methods and spreading the message is everyone’s job!

Prior to the Workshop

Prior to conducting this workshop, review the entire Leader’s Guide and complete the preparation steps as outlined. Additional details are included in the Preparation Section of this guide.

Goal and Learning Objectives

The goal of this workshop is to sharpen case manager skills around safe sleep for babies and practice delivering a conversation with caregivers. To achieve this goal, unit members will:

• Comprehend, understand and be able to share the ABC’s of safe sleep.

• Discuss and identify elements in the home that may indicate an

unsafe sleep environment.

• Identify and address biases around safe sleep practices and how to discuss these biases with families.

• Practice the conversation case manager’s will have with caregivers around safe sleep.

Timing It should take between 1½ - 2 hours to complete this learning session with your staff. Additional time is needed prior to this session for set up and for staff to be prepared to engage in this activity.

Contact for Questions

Questions about these materials? Contact: Kim Washington, DFCS Safety Coordinator [email protected]

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 3

Preparation Work out the Logistics

Schedule a Date and Time This workshop can be conducted in one 1½ -2 hour session. Sample schedule for completing the workshop in one day: Start time: 9:00 Activity 1: 9:00 – 9:30 Activity 2: 9:30-9:50 Break: 9:50-10:00 Activity 3: 10:00-11:00 This schedule provides you with 2 hours of actual time for the workshop. You may finish sooner, but this time should be set aside. You can conduct the workshop as a part of or in place of your regular unit meeting or schedule a different date specifically for the purpose of this workshop. This is also a good opportunity for team building with your unit by going to lunch together or completing a team building activity before starting the workshop. Conference Room and Equipment

• Room large enough to accommodate your entire unit Internet access

• Projection screen or blank wall that can be used for projection • LCD Projector • Computer with speakers

Materials:

• Copy of the leader’s guide for your use in the workshop • Copies of the workshop guide for each unit member • Flip chart paper and markers • Your password for accessing the DFCS online training system

Prepare Your Staff Once you have handled logistics, communicate with your staff to make them aware of the workshop. Share the purpose and what you hope to accomplish from the workshop.

Review Your Leader’s Guide

This leader’s guide includes steps and directions for completing the workshop activities as well as important content about practice related to safe sleep. Read through your entire leader’s guide at least a few days before the workshop to ensure you understanding of all the materials.

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 4

Activity  1  Learning  about  the  Importance  of  Safe  Sleep  

Time: 35 minutes

Overview This activity will set the foundation for the remainder of the workshop by ensuring that everyone has the same information about safe sleep. Objectives After viewing the video “What is Safe Sleep for Babies”, completing the assessment and receiving a print out the certificate of completion, unit members will:

• Discuss and clarify the A,B,C’s of safe sleep Steps 1. Open the workshop. 2. Gather certificates of completion and check

individual smartphones to insure the video has been downloaded and is ready for use.

3. Debrief the video and reflection questions with unit members and answer any remaining questions.

Notes: 1. Timing for unit members to complete the entire

online training (Modules 1, 2, & 3) of the “What is Safe Sleep for Babies” is imperative. At the completion, each staff member must take an assessment and score 80%. The certificate of completion should also be printed by each staff member and brought to the workshop. You may want to designate a set time for them to accomplish these tasks.

2. Try to conduct this workshop within 2 weeks of case managers completing the online training. Be sure to emphasize the importance of completing and hold them accountable for this task.

Materials The “What is Safe Sleep for Babies?” video is housed on the DFCS training site: www.gadfcs.org/training Log in page: User ID is your employee Identification number without dashes. Enter your training password. What Would You Like To Do page: • Click on the Online

Training Courses icon.

• Click on Social Services

• Click on the Professional Development tab

• Click on What is Safe Sleep for Babies

• Complete Modules 1, 2 & 3 before this workshop.

Set up your equipment (computer, LCD projector, screen) prior to the start of the meeting. Practice logging into the training site ahead of time to ensure you can access Module 3 at the training site.

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 5

Activity 1 Review of Safe Sleep Practice Step Duration Open the workshop 5 mins Collect the Certificate of Completion and check Case Manager smartphones to assure the Safe Sleep Video and caregiver resources have been downloaded into a folder on the phone.

10 minutes

Debrief “What is Safe Sleep for Babies” video 20 minutes Introduce Activity/Give Instructions SAY:

Today, we are going to work together to increase our skills around safe sleep for babies. The 2014 DFCS child death report indicates that 13 out of 27 cases had some relation to families not providing a safe sleep environment for their babies. According to Georgia Child Fatality Review, as a state, sleep related deaths continues to be the leading cause of preventable infant deaths. Our ability to understand the ABC formula for safe sleep and transfer this information to our families is critical to the well-being and safety of children. We have an opportunity within DFCS to increase caregivers’ education on safe to sleep which could potentially prevent a child from dying. The promotion of the safe sleep formula is everyone’s job including sharing this information with your family members and friends. Prior to coming today, each of you should have watched the “What is Safe Sleep for Babies” video, downloaded this video and resource handouts to your phone, completed the “What is Safe Sleep Train the Trainer” tutorial on how to use the downloaded video or flip chart, completed the assessment and printed a copy of the completion certificate. I need a copy of your completion certificate and to check to make sure you have downloaded the video to your phone. During the Professional Development Series Workshop, we will be:

• Discussing the information presented in both the “What is Safe Sleep for Babies” and the “What is Safe Sleep for Babies Train the Trainer” video;

• Discuss how you have been using this information with your families and; • Practice using the information with your families and others in the

community.

It is important for you to understand and know the ABC’s of safe sleep so that you feel comfortable having a conversation with caretakers and others who might need this information.

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 6

ASK the group: (open sharing)

Reflection Questions: Why is it important for a baby to sleep alone (A), and in their own space?

• When bed sharing: • Babies can fall asleep easily on a caregiver’s chest or lap. A child can slip off

of a person's chest or lap and become trapped between caregiver, couch, chair or headboard or foot board.

• There's a risk for rolling over on the baby or the baby getting tangled in sheets, blankets leading to suffocation.

• There's also a risk of the baby falling to the floor or becoming trapped between the headboard and footboard.

What reasons did the video give for placing a baby on their back (B) when sleeping? • Babies clear fluids more easily when sleeping on their back because the windpipe or

trachea lies on the top of the esophagus, which links to the stomach, any regurgitation like spit up or reflux, which comes through the stomach has to work against gravity to enter the windpipe which causes choking. On the stomach, any food or liquid thrown up or reflux will pull at the baby’s airway, making it easier for the baby to choke.

Describe  what  a  baby’s  crib/sleep  space  (C)  should  look  like?  • Crib with a firm mattress. • Tight fitted bottom sheet. • Nothing present that can pose a risk to suffocation or strangulation - e.g. blankets,

bumpers, toys and pillows.

What are your thoughts about how we’ve dealt with discussions around safe sleep with caregivers in the past? Have we always been as thorough as we should have? No. Remarks or message may have been inconsistent. Various brochures and educational information shared with caregivers also may have different messages. What do you think is the difference between telling caregivers about safe sleep and having a conversation? Research has shown that having a conversation and clarifying the information with the caregiver has a greater effect in moving the caretaker toward change. What population would you share this information with? This information should be shared with anyone who might be putting a baby to sleep or nap time. This could be the biological parent(s), foster and adoptive parents, a sibling, grandparent(s), aunt(s), uncle(s), neighbors, friends, day care centers, etc. Bonus: share with my family members too!

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 7

SAY:

Have any of you used the video or the flip chart to educate your caregivers? How did it go? How long did it take? Did they have any questions or concerns about what you were saying? How did you respond to those concerns? In the next section of the training, we’re going to watch the “What is Safe Sleep for Babies Train the Trainer” video as a unit that demonstrates how to use the flip chart or smartphone download with caregivers. We will discuss further learning methods and tips on how to have a “conversation” with the caregiver about safe sleep for their baby.

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Activity  2:  Reflection  on  Train  the  Trainer

Time: 20 minutes

Overview This activity addresses biases around the safe sleep model and provides an opportunity to discuss the importance of a conversation with the caregivers around the safe sleep for their baby. Objectives

• Address any personal biases around the safe sleep model.

• Review positive conversation with caregivers around Safe Sleep.

• Understand and be able to address questions caregivers have about sleeping with their baby

Steps 1. Debrief with the reflection questions

Materials Projector Computer

Other Resources

Activity 2 Debrief the Train the Trainer Video Step Duration Debrief the Train the Trainer Video using Reflection Questions

20 mins

SAY:

As you watched the Train the Trainer video you observed two different examples of conversations that might take place with the caregivers. It’s important for us to recognize our own feelings and emotions around safe sleep for babies in order to have quality conversations with caregivers.

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ASK: Reflection Questions:

Have any of you had similar questions or experiences as the caregivers in the video? What were they? • Yes to bed sharing. Response: Now we have research just as highlighted in the

video that tell us that sleeping on the back is the safest way. Yes to bumper pads, blankets in the crib. Response: Bumper pads can loosen and fall on the bed that may lead to suffocation. Blankets can cause overheating. A baby should wear no more than one time more than what we would wear.

Did you or anyone you know bed share with their baby and a sleep related death did not occur? If so, how do you feel about the information shared regarding the risks of sleep related deaths. Yes, no death from bed sharing- Response: risks now are too high. The Back to Sleep Campaign helped us to place babies on their backs, but it was soon discovered that babies are dying of another preventable death called SUID or Sudden Unexpected Infant Death) due to an unsafe sleep environment. We have to keep in mind, that caregivers may provide us with many reasons to bed share such as:

o personal experiences - bed sharing with an infant that didn't lead to a sleep related death.

o cultural values- certain cultures believe in bed sharing. o health community support for bed sharing- physicians, nurses, lactation

specialists, etc are in support of bed sharing...

Although caregivers may have many reasons, we must still remind them that the risk is too high in which 3 infants die per week. .

What did you think about the “conversations” that took place in the video? • The case manager was helpful, caring and knowledgeable. The caretaker seemed

interested and unaware of the risks. It seemed like the conversation was very helpful.

The case manager did a great job of making the caregiver feel comfortable during the discussion of safe sleep, what techniques did she use? • Engaging the caregiver, similar to the opportunities given in Solution Based Case

work coming soon; • Building rapport by congratulating the caregiver on just giving birth to a newborn; • Creating an environment open for further discussion by stating that questions can be

asked during the conversation; • Recognizing and acknowledging the caregiver's concerns; • Case Manager's demeanor showed compassion, empathy, care, concern and

physically provided direct eye contact, smiling, etc.

Why is it important to have a conversation rather than directly telling the caregiver of the dangers involving an unsafe sleep environment?

• Involving the caregiver and addressing concerns, questions and challenges will give more ownership towards following the recommendations.

If the caregiver expresses common concerns related to safe sleep such as the baby being cold without blankets, where would you locate the recommended response? • In the back of the What is Safe Sleep for Babies Flip. • Note: If you’re using the downloaded video, it’s very important that you familiarize

yourself with this information. This will enrich your conversation with the caregiver.

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Now that you've learned about the high risk for sleep related deaths, how will you approach caregivers about safe sleep practices, different than before? • Share the A, B, C’s- Alone, Back, Crib; Highlight additional educational information

with caregivers on the dangers of bed sharing and factors that cause an unsafe sleep environment (e.g. bed sharing, blankets, pillows, toys in the crib, smoking, over-heating, etc.).

From the Train the Trainer video we understand why it is so important to have a “conversation” with the caregiver versus telling them about safe sleep environments. In the next part of this workshop we will be practicing using either the flipchart or the video download.

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 11

Activity  3  Practicing  the  “conversation”  with  caregivers  around  safe  sleep  environments  for  their  babies

Time: 1 hour

Overview This activity provides an opportunity to practice using the flip chart or smartphone download to have a conversation around safe sleep. Objectives

• Using the information from the train the trainer, the flip chart and the smartphone download, participants will practice having a conversation with caregivers.

• Participants will become knowledgeable and

comfortable with the safe sleep materials Steps 1. Split the staff into groups of 3.

2. Provide instructions

3. At the end of the practice rounds, have teams

report out on their experience.

4. Reiterate the importance of having a conversation with the caregiver.

Materials Safe Sleep Flip Chart or Safe Sleep Video downloaded to Smartphone Caregiver Safe Sleep Challenges

Steps Duration Divide group into triads assigning the following roles: Caregiver, Case Manager and observer.

5 minutes

Provide instructions and give each caregiver role their challenge for understanding safe sleep.

40 minutes

Each triad report out on their experience. 20 minutes Discuss the importance of having a conversation with caregivers.

5 minutes

DO: 1. Divide the group into triads. Assign the following roles: Caregiver, Case Manager,

Observer 2. Following the instructions, there is a sheet of Caregiver Challenges. Print this

information and cut each challenge apart. Provide 3 caregiver challenges to each group (1 on each of the ABC’s). Each time the triad rotates to new roles a new challenge will be presented.

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3. Instruct triads to complete the following tasks:

§ Using either the flip chart or the video download, the case manager will practice presenting the information to the caregiver.

§ Using the assigned “Caregiver Challenge Sheet” the caregiver will explain to the case manager their challenges on safe to sleep practices.

§ Allow each triad to practice for approximately 5 minutes. Have the observer share their observations with the others in the triad and then rotate roles repeating activity with a new challenge for the individual role playing the case manager.

.

Facilitation Tip: You may want to divide the role play into the following segments so that each rotation continues the video and flipchart. This will reinforce their knowledge about the informtion contined in the flip chrt and video tool The first rottion would work through the A (Alone), 2nd rottion B (Back), and 3rd rotation C (Crib).

After teams have completed their tasks, have the observer in each triad share feedback from the practice session. SAY:

DO: Get each team to report:

§ Any difficulties in answering and responding to the caregiver challenges § Any gaps in their knowledge around safe sleep practices. § Their thoughts about safe sleep for babies.

SAY:

Now, let’s talk about what the observer shared during the practice sessions. Would someone like to begin?

It is critical that we share this information with caregivers. Just as important, are those who come into contact with the child on a temporary basis and providing a sleep environment for the child. This could be Grandparents, Aunts & Uncles, Friends, Neighbors, Baby sitters, Day Care Centers and others. Share this information with anyone who comes into contact with a baby. Remember that many of the child deaths are children that have not yet come to the agencies attention! This information should be shared on a broader scope with your community partners. Make sure they are aware of the “What is Safe Sleep for Babies” video so they can share with the families they come into contact with too!

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Professional Development Series: Discussing Safe Sleep for Babies with Caregivers March 2016 13

SAY:

HOW TO RECEIVE TRAINING CREDIT

Case Manager Credit Supervisors cut and paste these directions into an email for each of your staff. Log into the DFCS online training site at www.gadfcs.org and click on the “What is Safe Sleep for Babies” training. Select “Professional Development Series-Discussing Safe Sleep for Babies with Caregivers” Case Manager Post Training Activity. Follow the directions for receiving training credit for this activity. If you have questions, email Tanya Davis at [email protected]. Supervisor Credit Log into the DFCS online training site at www.gadfcs.org and click on the “What is Safe Sleep for Babies? training. Select “Professional Development Series-Discussing Safe Sleep for Babies with Caregivers” Supervisor Post-Training Activity. Follow the directions for receiving training credit for this activity. If you have questions, email Tanya Davis at [email protected].

Now that you have completed this Practice Development Series (PDS) as a case manager you will want to get training credit. I will be emailing each of you the directions. Please complete this as soon as possible to ensure you receive credit for our time together discussing and learning about safe sleep.

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Caregiver Challenge Sheet

A - Alone I don’t understand why I can’t lay down with my baby on the sofa to take a nap. My dad always slept like that with me.

B- Back My mom told me that the only way to put a baby to sleep is on their stomach. I am not sure why this isn’t the right way

C- Crib I bought beautiful bumper pads to go with my crib set and don’t understand why they can’t be in the bed.

A - Alone I really like to sleep with my baby in the bed. My mom slept with me and nothing happened.

B- Back I am that baby’s grandmother and I have been putting babies to sleep on their stomachs for years. That is the way my mother did it too and nothing has happened to any of the babies I kept.

C- Crib Sometimes when I come home from the store and bring the baby into the house in their car seat and he is asleep, I just let him there. I don’t understand why I can’t just let him sleep there.

A - Alone I’m afraid to leave my baby alone. I think he needs to be close to me when he sleeps.

B- Back I like to sleep on my stomach. I always put my baby down on his stomach to sleep.

C- Crib I keep my sister’s baby and use the old baby bed I have, it was good enough for all of my kids so I don’t understand why it isn’t any good any more.

A - Alone When I’m feeding my baby in the middle of the night in my bed, I’m so tired that sometimes I nod off My baby sleeps right there with me. Nothing has happened to my baby.

B- Back When I leave my baby at the daycare, sometimes the staff leave her in her car seat because she’s already asleep. Is this okay? I want my baby to be safe anywhere I leave her.

C- Crib My baby likes toys in the crib. It gives her something to do if she’s not ready to fall asleep yet.

A - Alone I’ve slept with my baby in the bed and nothing has happened.

B- Back When I was young the doctor’s told us to sleep the baby on their stomach and never put them on their back and nothing ever happened to the baby.

C- Crib My baby needs to have a blanket otherwise she will get cold.

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Please share the feedback you receive from your staff with the Professional Excellence Program. Your input and the input of your staff will help the program provide the type of learning experiences that staff need. Send your feedback, questions, and comments to: Tanya Davis at tdavis272gsu.edu