UVM Medical Center Research on Smart Bassinets is Advancing Infant Care

Burlington, VT - As a veteran nurse in the Neonatal Intensive Care Unit (NICU) at University of Vermont Medical Center, Melinda Pariser-Schmidt, MSN, RNC-NIC, IBCLC, understands the importance of safe sleep for infants, especially those facing serious medical conditions. 

So when she learned about an opportunity to trial a new innovation for infants with Neonatal Abstinence Syndrome (NAS) in the Neonatal Intensive Care Unit (NICU) at UVM Children’s Hospital, Pariser-Schmidt jumped at the chance. Her goal: determine whether responsive bassinets – baby beds with built-in technology and sensors designed to help babies relax and sleep longer – could help support opioid-exposed infants and the nurses who care for them. 

After months of planning and with the support of her unit’s leadership, Pariser-Schmidt incorporated the smart bassinets into the NICU’s care of infants with NAS). The nurse-led quality improvement project is especially timely and impactful in Vermont, she said, because of the state’s ongoing struggles with rates of substance use that are higher than the national average. 

“We’re in a unique situation where we have a small state that struggles with substance use,” said Pariser-Schmidt. “If you have that challenge within the adult population, you’re going to have the risk for exposure in the neonatal population.” 

Pariser-Schmidt’s findings, which came from chart reviews and sleep analysis of NICU patients with NAS from December 2020 through September 2022, were encouraging. She found that the use of smart bassinets reduced patients’ average length of stay in the NICU by more than 17%, or between five and six days, and decreased poor sleep scores by more than 41%. The study monitored about 100 infants, according to findings published last year by the National Association of Neonatal Nurses.  

Pariser-Schmidt’s colleagues also reported benefits, with 84% of nurses surveyed reporting the bassinets saved them up to two hours per shift – allowing them to provide more care to patients across the NICU. 

In addition to improving comfort and decreasing time in the hospital, said Pariser-Schmidt, another benefit of the bed is the ability of NICU staff to consistently model safe sleep for families and caregivers. NICU patients are among those infants most at-risk for Sudden Infant Death Syndrome (SIDS). 

“One of the biggest long-term goals is keeping these infants in a safe sleep position,” said Pariser-Schmidt of one of the challenges of caring for infants experiencing NAS. “Safe sleep positionings can reduce the risk of sudden infant death syndrome, and now every baby who comes to the NICU for neonatal abstinence is in one of those beds.” 

Advancing Care for Infants with Neonatal Abstinence Syndrome 

When a baby born at UVM Medical Center is known to have been exposed to certain medications or substances in utero, they are kept in the hospital for 96 hours – a longer-than-normal period of postpartum observation that allows the hospital’s maternity and inpatient pediatric care teams to monitor them for signs of NAS. 

NAS is a spectrum of symptoms experienced by infants due to withdrawal after being exposed to certain substances before birth. While NAS is most commonly associated with opioid use, it can occur after an unborn child is exposed to other substances, including some that are prescribed. According to data from a 2023 study published in the Maternal Child Health Journal, Vermont has the second-highest rate of NAS and substance exposure cases nationwide. 

Infants experiencing the most severe symptoms may need medications like methadone. Whenever possible, NICU teams provide care using the “Eat, Sleep, Console” model of care, which studies have shown significantly decreases patients’ time in the NICU. 

The challenge, said Pariser-Schmidt, is that historically strategies for comforting these patients may involve the use of baby seats or swings, which do not meet safe sleep guidelines established by the American Academy of Pediatrics (AAP). 

“These methods are not safe sleep,” she said. “It’s very important for us to demonstrate what we teach to these families.” 

One of the most basic benefits of a smart bassinet is that it allows NICU care teams to observe safe sleep practices while also improving sleep for infants with NAS. That’s critical, said Pariser-Schmidt, because these infants are at increased risk of SIDS. 

Combatting Sudden Infant Death Syndrome 

The hospital’s youngest patients face a wide range of challenges, complications and risks – including an increased risk of SIDS, a mysterious and undetectable condition that results in the unexplained death of an infant under the age of one year. While the rate of SIDS has varied since the 1980s and has been reduced significantly due to safe sleep education campaigns, it remains one of the top causes of infant death in the United States. 

Pariser-Schmidt said the hospital’s NICU, which has long been a pioneer of neonatal medicine, is once again at the forefront of innovation that could significantly improve care and reduce risks for the UVM Medical Center’s most vulnerable patients. 

“We really are on the front edge of what is going to be considered best practice,” she said, referring to the use of smart bassinets. “We’re really proud that we’re using this technology for our patient population and to support our nursing staff.” 

Currently only about 165 hospitals nationwide use smart bassinets, according to manufacturers.