Analysis of Child Passenger Safety Restraint Use at a Pediatric Emergency Department

University of Alabama Birmingham, Medical School, Birmingham, AL, USA.
Pediatric emergency care (Impact Factor: 1.05). 02/2011; 27(2):102-5. DOI: 10.1097/PEC.0b013e3182094312
Source: PubMed

ABSTRACT The objectives of the study were to determine the number of children properly restrained during transit to a pediatric emergency department for care and to ascertain parental knowledge of Alabama laws and American Academy of Pediatrics (AAP) guidelines and where they obtain this information.
An emergency department (patient care rooms) waiting area, convenience sample of Alabama parents who have children younger than or 13 years of age were surveyed over a 5-week period. Appropriate use of child passenger safety (CPS) restraints was determined using Alabama law and AAP recommendations. Use of Car Seat Checks provided by Children's Hospital and Safe Kids, knowledge of Alabama laws and CPS guidelines, and the source of information used by parents were ascertained.
Among 525 patients identified, 520 (99.0%) participated. Appropriate use per Alabama law and AAP guidelines was 72.3% and 60.6%, respectively; 5.0% were unrestrained. Booster seats were the most commonly misused restraint. Car seats were reportedly used correctly by 81.9%. Parents who had used the Car Seat Checks program had correct booster seat and car seat use rates of 95.8% and 61.5%, respectively. Unfortunately, only 31.2% of patients had knowledge of the Car Seat Checks program, and only 40.6% knew the current law. Most often, parents stated that the hospital where their child was born was the primary (and sometimes only) source of CPS information.
This study illustrates the need for improving parental knowledge of appropriate child passenger restraint use (especially booster seats) and Car Seat Checks programs. Car seat program assistance is associated with high levels of appropriate use.

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    ABSTRACT: 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.
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