Article

Parent Education by Maternity Nurses and Prevention of Abusive Head Trauma

Department of Pediatrics, New York Medical College, Valhalla, NY 10595, USA.
PEDIATRICS (Impact Factor: 5.47). 11/2011; 128(5):e1164-72. DOI: 10.1542/peds.2010-3260
Source: PubMed

ABSTRACT

A consortium of the 19 community hospitals and 1 tertiary care children's hospital that provide maternity care in the New York State Hudson Valley region implemented a program to teach parents about the dangers of shaking infants and how to cope safely with an infant's crying. This study evaluated the effectiveness of the program in reducing the frequency of shaking injuries.
The educational program, which was delivered by maternity nurses, included a leaflet explaining abusive head trauma ("shaken baby syndrome") and how to prevent it, an 8-minute video on the subject, and a statement signed by parents acknowledging receipt of the information and agreeing to share it with others who will care for the infant. Poisson regression analysis was used to compare the frequency of shaking injuries during the 3 years after program implementation with the frequency during a 5-year historical control period.
Sixteen infants who were born in the region during the 8-year study period were treated at the children's hospital for shaking injuries sustained during their first year of life. Of those infants, 14 were born during the 5-year control period and 2 during the 3-year postimplementation period. The decrease from 2.8 injuries per year (14 cases in 5 years) to 0.7 injuries per year (2 cases in 3 years) represents a 75.0% reduction (P = .03).
Parent education delivered in the hospital by maternity nurses reduces newborns' risks of sustaining an abusive head injury resulting from shaking during the first year of life.

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Available from: Patricia A Patrick, Nov 19, 2015
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    • "Dias et al. (2005) reported a decrease in the incidence of AHT following a coordinated, hospital-based, parent education program delivered in hospitals, targeting parents of all newborn infants. Another program involved education of parents by maternity nurses and indicated a decrease in the incidence of AHT in the first year of life (Altman et al., 2011). A triple-dose strategy for the prevention of AHT recently proposed by Stewart and colleagues includes parental education on crying patterns, coping strategies, and the dangers of shaking a child. "
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    ABSTRACT: Objective: Abusive head trauma (AHT) is a leading cause of severe injury in maltreated children in the United States. There is little research from nationally representative datasets available to characterize young children who had AHT compared to non-abusive head trauma (NAHT). Methods: Using the recent CDC AHT case definition, we performed a retrospective analysis of 2000, 2003, 2006 and 2009 hospitalization data using the Kids' Inpatient Database (KID) from the Healthcare Cost and Utilization Project. Logistic regression was used to compare AHT to NAHT patients <2 years of age. Socio-demographic data and indicators of socioeconomic status (i.e., insurance status and household income), presence of chronic conditions, injury severity (i.e., length of hospital stay and vital status), hospital specialization (i.e., hospital type), hospital region, and season of admission were used as independent variables. Results: A weighted sample of 7,603 AHT and 25,339 NAHT patients was identified. National rates for AHT were 39.8 per 100,000 population for children <1 year and 6.8 per 100,000 population for children 1 year old. Compared to NAHT, children with AHT were more often <1 year of age (adjusted odds ratio [aOR]=2.66; 95% confidence interval [CI]: 2.35-3.01), male (aOR=1.10; 95% CI: 1.01-1.20), enrolled in Medicaid (aOR=2.78; 95% CI: 2.49-3.11), hospitalized longer (aOR=8.26; 95% CI: 7.24-9.43), died during hospitalization (aOR=5.12; 95% CI: 4.01-6.53), and seen at children's hospitals (aOR=1.97; 95% CI: 1.63-2.38) and hospitals outside the Northeast [aOR=2.65 (95% CI: 2.10-3.33) for the Midwest, 1.90 (95% CI: 1.52-2.38) for the South and 1.93 (95% CI: 1.45-2.57) for the West, respectively]. Conclusions: The results confirm that injuries from AHT are more severe and more often lethal than other head injuries. Socioeconomically disadvantaged families with children <1 year are an important focus for primary prevention. The associations of AHT, compared to NAHT with hospital type and hospital region warrant further investigation. Referral or reporting patterns, or true differences in the incidence may contribute to the identified associations.
    Full-text · Article · Mar 2013 · Child abuse & neglect
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    • "Dias et al. (2005) reported a decrease in the incidence of AHT following a coordinated, hospital-based, parent education program delivered in hospitals, targeting parents of all newborn infants. Another program involved education of parents by maternity nurses and indicated a decrease in the incidence of AHT in the first year of life (Altman et al., 2011). A triple-dose strategy for the prevention of AHT recently proposed by Stewart and colleagues includes parental education on crying patterns, coping strategies, and the dangers of shaking a child. "

    Full-text · Article · Sep 2012 · Annals of Epidemiology
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    ABSTRACT: This review is designed to update the general pediatrician with information about current child maltreatment literature. The authors have selected salient articles, which inform daily practice of any professional involved in the care of children who may be at risk of child abuse. The field of child abuse pediatrics continues to engender controversy in both medical journals and courtrooms. As scrutiny about the basis for the diagnosis increases, clinicians and researchers work to build a solid base of scientific evidence with thorough and well-designed studies. This is most evident with regards to abusive head trauma, wherein both lay and scientific press challenge the possibility that infants can be severely injured or killed by shaking, blunt force trauma, or both. Child abuse pediatrics is a well-established and credible medical field. Although child physical and sexual abuse are age-old problems, public acknowledgement and intervention models are relatively new, and medical literature continues to reflect an increasing and deeper understanding of the impact of abuse throughout the world.
    No preview · Article · Apr 2012 · Current opinion in pediatrics
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