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A computerized child passenger safety screening program in the emergency department
Kathleen Kiley1, Frances Damian, Whitney MacClaren
1From the Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston MA.
Insights
Implementing an emergency department (ED) child passenger safety program using a computerized screening tool effectively increased car seat usage and distribution. This initiative successfully improved child passenger safety in pediatric patients.
Area of Science:
- Pediatric injury prevention
- Public health interventions
- Emergency medicine
Background:
- Emergency departments (EDs) are crucial sites for pediatric injury prevention.
- Child passenger safety is a key area for prevention initiatives.
- Effective tools are needed to identify and address car seat needs in children.
Purpose of the Study:
- To evaluate the implementation of an ED-based child passenger safety program.
- To assess the effectiveness of a computerized screening tool for identifying car seat needs.
- To improve car seat usage and distribution for children under 8 years old.
Main Methods:
- Development of an ED child passenger safety program including a computerized screening tool.
- Implementation of the screening tool into the initial nursing assessment.
- Phased approach to mandatory screening and nursing education to increase compliance.
Main Results:
- Screening compliance increased from 17% to 87% over the study period.
- The number of car seats distributed increased significantly with improved screening rates.
- The computerized tool demonstrated effectiveness in identifying children needing car seats.
Conclusions:
- Child passenger safety programs can be successfully implemented within ED settings.
- A computerized nursing screening tool is effective in increasing screening compliance.
- The program successfully increased the provision of needed car seats to pediatric patients.
Objectives:
The emergency department (ED) can be an effective site for pediatric injury prevention initiatives, including child passenger safety. The objectives of this study were to evaluate the implementation of an ED child passenger safety program and to analyze the effectiveness of a computerized screening tool to identify car seat-related needs for children younger than 8 years.
Methods:
An ED-based group developed a child passenger safety program including (1) a computerized screening tool to assess the use of car seats in children younger than 8 years; (2) child passenger safety education, including state law; and (3) distribution of appropriate car seats for patients discharged from the ED. In July 2011, the screening tool was added to the initial nursing assessment. In January 2012, nursing education was performed to increase compliance with screening. In April 2012, the tool was made a mandatory field in the computerized initial nursing assessment.
Results:
From August 1 to December 31, 2011, 17 % (2270/13,637) of eligible children had computerized screenings performed; 18 car seats were distributed. From January 15 to March 15, 2012, 32% (2017/6270) of eligible children were screened; 9 car seats were distributed. From March 16 to May 19, 2012, 56% (3381/6063) were screened; 22 car seats were distributed. Screenings increased further from May 20 to July 25, 2012, with 87% (5077/5827) completed; 31 car seats were distributed.
Conclusions:
A child passenger safety program can be successfully implemented in the ED. A computerized nursing screening tool increases compliance with screening and providing needed car seats.
