Implementation of a risk assessment tool to support a strategic, evidence-informed and integrated approach for the prevention of Sudden Unexpected Death in Infancy

The aim of this research is to reduce Sudden Unexpected Death in Infancy (SUDI) deaths and eliminate the inequity in SUDI rates for Maori and Pacific people in New Zealand. Each year around 44 babies die in New Zealand from SUDI and 8-10 of these babies are from South Auckland. SUDI can be prevented for most babies. The challenge is for health care providers to be knowledgeable when faced with the complexities of SUDI risk assessment, and then engage effectively with families to support SUDI protective behaviours. Successful SUDI prevention programmes require identification of those at high risk and a system wide, consistent SUDI prevention advice and model of care tailored for those at increased risk. The last decade has seen the development of ‘on-bed’ baby beds (wahakura and Pepi-pod) and availability of these baby beds in a safe sleep programme has, in part, resulted in a 25% reduction in SUDI in New Zealand from 2010 to 2015. However, SUDI rates remain higher in New Zealand than all other developed nations. A robust systematic approach to ensure universal, standardized and accurate SUDI risk assessment is lacking. The Ministry of Health have set a target to reduce SUDI nationally to six per year by 2025 (0.1/1000 births). We believe this is possible, but we need to be both systematic and effective with interventions. The Safe Sleep Calculator is a web-based SUDI risk assessment tool that makes it easy for healthcare professionals to consider all the SUDI risk factors and guides them in the advice and support they can provide to prevent SUDI. Our data show that 90% of SUDI cases would be predicted to be in the ‘higher risk’ group using the Safe Sleep Calculator. This makes it an excellent prioritisation tool to maximise the impact of intervention activities. Cure Kids funding has enabled the Safe Sleep Calculator to be successfully co-designed in Primary Care over the past 2 years. Planning is now underway to widely implement the Safe Sleep Calculator in Primary Care. There is also considerable interest internationally (Australia, USA and UK) in this revolutionary approach to targeted prevention.