Activity

By statute, pediatric passengers transported in motor vehicles need to be appropriately restrained. The National Highway Traffic Safety Administration (NHTSA) estimates that currently only 2% of children do not wear safety restraints. This study aimed primarily to evaluate the use of pediatric restraints (seat belts) in motor vehicle collisions (MVCs) transported to our Level I pediatric trauma center (PTC) compared with historical NHTSA controls.

A 4-year review utilized our Level I PTC registry for patients younger than 16 years, involved in an MVC. Appropriate booster seat/child restraints were verified by EMS, fire rescue, and patient/family. Odds ratios were used to compare occurrences and χ for categorical values with significance defined as p <.05.

A total of 685 pediatric patients in MVCs were admitted to our PTC during the study period. Only 39 of 685 (5.7%) pediatric patients were in restraints. Based on the NHTSA historical controls, 671 of 685 (98%) children would have been expected to be using restraints (5.7% vs. 98%, p < .01). The odds ratio of lack of use of child restraints or seat belts in pediatric trauma population was markedly higher compared with NHTSA historical controls (odds ratio 793.9, 95% confidence interval 427.02-1475.98, p < .0001).

Astonishingly low rates of child restraints and seat belt use in pediatric patients in MVCs, requiring admission to a PTC, indicate the need for better injury prevention programs, and parental or driver education on risks associated with lack of restraints.

Astonishingly low rates of child restraints and seat belt use in pediatric patients in MVCs, requiring admission to a PTC, indicate the need for better injury prevention programs, and parental or driver education on risks associated with lack of restraints.

Adverse childhood experiences, such as child maltreatment, have been shown to result in negative health outcomes throughout an individual’s life. Previous research has found that children with a prior allegation of maltreatment die due to unintentional injuries at twice the rate of children who were not reported to Child Protective Services, however, death is only one outcome of injury and many unintentional injuries do not result in death.

This secondary analysis of Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) data examined predictors of injury in children whose family has been reported to CPS utilizing the ecological-developmental framework theoretical domains which guided LONGSCAN child characteristics, family/caregiver characteristics, parental and family functioning, extrafamilial relationship skills, community ecology, child outcomes, and systems of care factors.

Logistic regression modeling showed that the likelihood of childhood injury significantly increased for those children who did not recognize or appropriately respond to cues of ending a conversation (OR=.37), caregiver reported child always has a good place to play in their neighborhood (OR=1.57), and child utilized educational services (OR=2.06).

Understanding the predictors of injury is necessary to implement injury prevention interventions targeting the unique needs of this vulnerable population and increase awareness of prevention strategies to reduce childhood injuries.

Understanding the predictors of injury is necessary to implement injury prevention interventions targeting the unique needs of this vulnerable population and increase awareness of prevention strategies to reduce childhood injuries.

Shaken baby syndrome/abusive head trauma (SBS/AHT) is the leading cause of child abuse death. Our institution piloted an evidence-based educational program to increase nurse and caregiver knowledge about SBS/AHT.

Nurses participated in a pretest survey, completed online implementation training, and then were given a posttest survey to determine the change in SBS/AHT knowledge. Once trained, nurses disseminated information to caregivers with children younger than 6 months. Caregivers (N = 87) watched an educational video, reviewed information in a booklet with a nurse, and participated in teach-back related to key points of the intervention in both a hospital and the community setting.

Prior to the education, nurses (n = 115) scored 8.03 out of 10.00 on the SBS/AHT assessment. Pelabresib mouse Following the intervention, nurses (n = 120) scored 9.00 out of 10.00 on the assessment, t(233) = -6.61, p < .001. During education, caregivers (n = 69) were able to recall 8.55 out of 12 key educational components. In the community setting, caregivers (n = 18) worked together to recall 12 out of the 12 key components. Caregivers were most likely to recall ways to comfort their crying baby (94%) and why shaking a baby is dangerous (93%).

This pilot study significantly increased nurses’ knowledge of SBS/AHT and provided education to caregivers about SBS/AHT.

This pilot study significantly increased nurses’ knowledge of SBS/AHT and provided education to caregivers about SBS/AHT.

Pediatric Level I trauma centers often experience patient volume surges. The increase stresses the emergency department, and usual patient care areas become inadequate. The purpose of this quality improvement study is to describe the implementation and analysis of an alternate care site to facilitate patient flow during seasonal patient volume surges.

This initiative used a nonequivalent historical control group posttest-only design. An alternate care site was selected because of its size, temporary nature, low cost, and proximity to the emergency department. The alternate care site was activated between January and March 2019 using the following criteria the total number of patients in waiting room 30 or more and wait times 2.5 hr or more. Outcome metrics include total census, length of stay-admissions, length of stay-discharges, left without being seen, hours per patient visit, patient satisfaction scores, and process metrics. Descriptive statistics and t tests were used to determine differences betweenilization, response, and treatment of patients. The alternate care site decreased median length of stay for admissions, discharges, and who left without being seen while keeping hours per patient visit and patient satisfaction constant. Future studies should confirm findings by testing the alternate care site in other hospitals and settings and should consider formally evaluating staff satisfaction.