Available online 8 September 2022

AbstractObjective

To assess the self-reported knowledge, education, and practices related to hip-healthy swaddling of newborns among nurses, how they teach this technique to parents, and the relationships among these factors.

Design

Descriptive cross-sectional exploratory survey.

Setting

Academic women and children’s hospital with an average of 4,500 annual births.

Participants

One hundred four registered maternity nurses who work primarily in the maternity unit.

Methods

At three staff meetings, we surveyed maternity nurses to determine their knowledge, education, and practices related to hip-healthy swaddling and how they teach this technique to parents. We analyzed results using descriptive statistics and chi-square and Fisher’s exact tests.

Results

Of the 156 nurses in the maternity unit, 104 attended three staff meetings and completed the survey. Among the participants, 18.9% (18/95; 9 participants did not respond) were unable to identify the correct hip swaddling position. Overall, 64.2% (61/95; 9 participants did not respond) reported that they received education on general swaddling technique, yet 14.8% (9/61) of these participants were unable to identify the correct hip-healthy swaddling position. Among the participants, 99.0% (103/104) reported that nurses teach parents how to swaddle infants rather than other health care providers; 12.5% (13/104) of participants responded that medical doctors provide training as well. Overall, 67.0% (69/103; 1 participant did not respond) reported that they taught parents in >75% of parent interactions.

Conclusion

Our results illustrate a gap in knowledge about hip-healthy swaddling among the maternity nurses who participated in this survey and a need for further education.

Section snippetsDesign

The design of this study was a descriptive, cross-sectional survey developed by the investigators. We based survey questions on observations from the principal investigator’s (S.P.) pediatric orthopedic clinic when a new parent reported learning an incorrect swaddling technique from maternity nurses during her stay at our hospital. She continued to swaddle in this manner for 1 month before her infant presented to the pediatric orthopedic clinic with a diagnosis of hip dysplasia. Based on this

Results

Among 156 nurses who met the inclusion criteria, 104 (67%) attended three staff meetings during which surveys were distributed (n = 33, 38, and 32 for Days 1, 2, and 3, respectively; 1 with no completion date recorded). All 104 maternity nurses who attended the staff meetings completed the survey. Regarding the practice of hip-healthy swaddling, 78.4% (80/102) of participants reported that they swaddled infants 75% to 100% of the time (see Table 3), and 80.3% (82/102) of participants reported

Discussion

The purpose of this study was to assess the self-reported knowledge, education, and practices related to hip-healthy swaddling of newborns among maternity nurses, how they teach this technique to parents, and the relationships among these factors. Although the participants in our study reported swaddling most of the infants in their care and were often responsible for teaching swaddling techniques to parents, fewer than two thirds (61/95) of participants reported being formally trained in

Conclusion

The results of this study suggest that there is a need to develop and implement a standardized, evidence-based, hip-healthy swaddling education curriculum and resources for maternity nurses, who are uniquely positioned to help parents learn how to safely position and swaddle their infants in the hospital and at home during the crucial first few months of hip development.

Acknowledgment

The authors acknowledge Dominika Maglasang, MSN, CPNP, for help with the collection of survey data.

Conflict of Interest

The authors report no conflicts of interest or relevant financial relationships.

Funding

None.

Brian Vuong, BS, is a clinical research coordinator associate, Department of Orthopaedic Surgery, Division of Pediatric Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

References (30)M. HeneghanDevelopmental dysplasia of the hip

Journal of the American Academy of Physician Assistants

(2021)

B.A. Kelly et al.Swaddling and infant sleeping practices

Journal of Community Health

(2017)

P. Kotlarsky et al.Developmental dysplasia of the hip: What has changed in the last 20 years?

World Journal of Orthopedics

(2015)

A. Leotsakos et al.Standardization in patient safety: The WHO High 5s project

International Journal for Quality in Health Care

(2014)

R.T. Loder et al.The demographics of developmental hip dysplasia in the Midwestern United States (Indiana)

Journal of Children’s Orthopaedics

(2015)

View more references

Brian Vuong, BS, is a clinical research coordinator associate, Department of Orthopaedic Surgery, Division of Pediatric Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Joanne Zhou, MD, is a resident physician, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Meewon Park, MD, is a resident physician, Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA.

Nicole Segovia, MPH, is a biostatistician, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Meghan Imrie, MD, is a clinical associate professor, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

Stephanie Y. Pun, MD, is a clinical associate professor, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA.

View full text

© 2022 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.