Child Injury Prevention Research Articles

Introduction to the Special Section on Child Injury: Reflecting on the Impact of Pediatric Psychology on Child Injury Prevention, Past and Present

Introduction to the Special Section on Child Injury: Reflecting on the Impact of Pediatric Psychology on Child Injury Prevention, Past and Present

Evaluating the effect of child home safety training upon three family support practitioner groups: a mixed-methods study.

Unintentional injuries in the home contribute substantially to preschool child morbidity and mortality. Practitioners such as health visitors, family mentors and children's centre staff are well-positioned to facilitate child injury prevention by providing home safety advice to families, and training may enhance their ability to do so. We aimed to assess the impact of child home safety training for these practitioners. An explanatory mixed-methods design was used. Practitioners completed questionnaires before, and up to 7 months after, receiving child home safety training and took part in interviews. Seventy-eight health visitors, 72 family mentors and 11 children's centre staff members completed questionnaires. Items were used to calculate scores on home safety knowledge, confidence to provide home safety advice and belief that child home safety promotion is important. Thematic analysis of interviews with seven health visitors and nine family mentors, open-ended responses to the questionnaires and an additional evaluation form was conducted to explore attendees' perceptions of the training and its impact. In addition, seven health visitors and six children's centre staff who had received no training were interviewed. Knowledge was greater post-training than pre-training across all participants (p < .001). When practitioner groups were analysed separately, there were significant increases in family mentors' knowledge (p < .001) and belief (p = .016), and health visitors' confidence (p = .0036). Qualitative findings indicated that most training session attendees valued the training, believed their practice relating to child home safety had improved as a result, and felt further similar training sessions would be beneficial. Those who had not attended the sessions described a need for more child home safety training. Delivering training to practitioners providing child home safety promotion to families with preschool children can enhance injury prevention knowledge, beliefs and confidence and positively impact on home safety promotion by practitioners.

Prevention of Injuries in Children with a Peripheral Intravenous Catheter: A Modified Evidence-Based Nursing Practice Guideline

Many children in African hospitals need a peripheral intravenous catheter (PIVC). Babies and children are particularly susceptible to serious harm from PIVC-related injuries. Nurses often regard a PIVC as a routine, low-risk intervention. Globally recommended practices include establishing a structured care pathway, recognising that PIVC management begins before insertion. Evidence-based care for children with PIVCs reduces complications and healthcare costs. Existing guidelines on managing PIVCs in infants and children are generally written for higher-resourced settings or are not specific to a paediatric population. This study aimed to review existing practice guidelines to provide accessible and implementable guidelines for caring for hospitalised babies and children up to the age of 13 years, in lower-resourced paediatric in-patient health facilities in Namibia. We applied a structured process for modifying existing high-quality guidelines developed in higher-resourced settings for implementation in lower-resourced contexts. This process involved identifying suitable guidelines for modification and rigorous guideline modification, resulting in a context-specific guideline. The modified guideline ensured that recommended practices related to pain management, difficult insertions and infection prevention are implementable. However, seeing PIVCs as unlikely to cause serious harm can lead to insufficient assessment and surveillance of PIVC injuries. We therefore produced a user-friendly guideline focused on high-impact areas of nursing practice, emphasising that nurses can avoid injury to children by properly managing a PIVC.

Home-based childhood injury prevention Jeddah Saudi Arabia

Home-based childhood injury prevention Jeddah Saudi Arabia

Child injuries in Lebanon: assessing mothers’ injury prevention knowledge attitude and practices

BackgroundChildhood injury is a neglected public health problem with a sizeable burden on children’s well-being and their families. This study aims to describe the pattern and types of childhood injuries and to determine the level of mothers’ Knowledge, Attitude, and Practices (KAP) towards childhood injury prevention in Lebanon. The study further examines the association between childhood injury occurrence and mothers’ supervision.MethodsThis cross-sectional study recruited mothers of children aged up to 10 years from multiple sites (i.e., a medical center, a private clinic, a healthcare facility, and a refugee camp clinic). Data were collected on mothers’ KAP toward childhood injuries using self-administrated questionnaires. A summation score for KAP correct answers was calculated and descriptive and statistical analyses were performed to measure the association between the outcomes.ResultsA total of 264 mothers were surveyed and injury data were collected on their 464 children. The prevalence of childhood injury was 20% in the past 12 months, mostly sustained by males (53.8%) and children aged 5–10 years (38.7%). The most common type of injury was fall (48.4%), followed by burns (%7.5), and sports injuries (7.5%). Hospitalized children were more likely to be males and older than 5 years (p < 0.001). More than one-third of the mothers demonstrated poor knowledge, while the majority showed poor practice (54.4%), and fair attitude (45.6%) towards child injury prevention. Children of working mothers have three times higher odds of sustaining injuries (OR: 2.95, 95% CI: 1.60;5.47) compared to those of non-working mothers, accounting for possible confounders (p = 0.001).ConclusionChildhood injuries represent a major health problem in Lebanon. Findings from this study showed that mothers are less knowledgeable and unprepared to prevent their children from getting injured. Educational programs are much needed to address the gap in the mothers' KAP toward child injury prevention. Further studies are recommended to understand the cultural context and examine its key determinants to identify effective strategies and develop tailored interventions for preventing childhood injuries.

What children’s perspectives on safe and dangerous outdoor play can tell us about their risk-seeking and injury experiences: ‘You don’t feel right doing the thing that got you hurt’

BackgroundUnintentional injuries are a leading cause of children’s hospitalisations and death globally and are thus a pressing public health concern. Fortunately, they are largely preventable, and understanding children’s perspectives on...

Abdominal Trauma in Children in the Pediatric Surgery Department of the Hospital in Mali

Abdominal trauma is a shock of any type exerted on the stomach. Traumatic lesions of the abdomen are very frequent and very varied. It can be closed or open. According to the world report on the prevention of injuries in children established in 2004, the sex ratio is between 3/1 and 5/1 in favor of boys. The objective was to write the epidemiological, clinical and therapeutic characteristics of abdominal trauma in children under 0 to 15 years old.

Pilot evaluation of a virtual training program for child injury prevention.

Unintentional injuries are a leading cause of child death. The present study evaluated the effectiveness of a behavioral injury prevention program for children aged 3-18 years and their caregivers. To accommodate families during the Coronavirus-19 pandemic, training was modified to be delivered virtually. Forty-one children aged 3-18 years and 14 parents/caregivers of children aged 3-5 years attended one of several 4-hour online injury prevention training sessions directed toward residents of Washington state. Training was targeted to three different developmental stages (ages 3-5, 6-12 and 13-18 years). Study outcomes included knowledge about injury prevention strategies, perceived vulnerability for injury, self-efficacy to engage in safety behaviors and behavioral intentions to be safe. Following training, participants showed improved self-efficacy to stay safe, excellent knowledge about the learned material and increased behavioral intention to engage safely. There was minimal change in perceived vulnerability to injury among children; caregivers of young children felt their children were somewhat less vulnerable to injury following the training. Almost all participants said they would recommend the program to others. Results suggest that a virtual behavioral training program delivered remotely is feasible and may be effective to create behavior change and reduce child injury risk. Given its scalability and reach, such programs are recommended for further study, refinement and, if demonstrated effective in larger-scale controlled trials, dissemination to address the leading cause of child mortality in the United States, unintentional injury.

Oxygen saturation probe-related pressure injury prevention in children on an inpatient pediatric unit: a best practice implementation project.

The aim of this project was to increase compliance with rotation and documentation of rotation of oxygen saturation probes to reduce medical-device-related pressure injuries in children on a pediatric inpatient unit. There are a multitude of factors that place hospitalized children at an increased risk for medical-device-related pressure injuries. Evidence supports the rotation of medical devices, if appropriate, at least twice daily to minimize the risk of medical-device-related pressure injuries in hospitalized children. The project used JBI's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for encouraging evidence-based practices. A baseline audit was conducted, followed by the implementation of targeted strategies. The project was completed with a follow-up audit to determine change in practice. The baseline audit revealed significant deficits in two of the seven audit criteria. Barriers to the rotation of oxygen saturation probes and the assessment of skin under oxygen saturation probes were identified by the project team and an electronic health record (EHR) documentation change was implemented. Follow-up audits were not conducted on the five criteria that showed high compliance at baseline. For the remaining two audit criteria, data revealed no improvement in one of the criteria (3% compliance at both baseline and follow-up audits) and an increase from 0% compliance to 43% compliance in the second criterion. Optimizing EHR documentation, specifically ease and efficiency of EHR documentation, has the potential to positively impact clinical practice.

Characteristics of unintentional childhood injury during COVID-19: a single-center comparative study.

There are many articles related to child injuries during the coronavirus disease of 2019 (COVID-19) in other countries, but only few studies in this field in China. This study analyzes the clinical characteristics of unintentional childhood injury during the pandemic, to provide reference for the prevention of unintentional childhood injury in the context of pandemic. A comparative study was performed on the medical data of 2,497 children with unintentional injury who were hospitalized at Chengdu Women's and Children's Central Hospital between 1 January, 2018 and 31 May, 2021. The study period was divided into 2 periods, before the pandemic (1 January, 2018 to 31 May, 2019), during the pandemic (1 January, 2020 to 31 May, 2021). The number of unintentional childhood injuries and age distribution before and during the pandemic were compared. Group differences were examined using Mann-Whitney U for continuous variables and Chi-squared or Kruskal-Wallis tests for categorical variables. There were significant differences in age, accident location, hospitalization days, and medical expenses before and during the pandemic (P<0.05). During the pandemic, the number of children's unintentional injuries increased by 34.24% (1,066 vs. 1,431, P=0.000), and the significantly increased types of unintentional injuries included foreign bodies, falls, crush injuries, and sharp injuries. During the pandemic, the highest proportion of unintentional injury to children was foreign bodies, whereas the proportion of falls was the highest before the pandemic. During the pandemic, the number of foreign body injuries in toddler was significantly higher than before the pandemic (P=0.001), but the number of falls, crush injuries, and sharp injuries in preschooler was significantly higher (P<0.05). In the circumstance of the COVID-19, the number of foreign bodies, falls, crush injuries, and sharp injuries, in children increased significantly. It is necessary to strengthen the prevention of foreign bodies in toddler, and falls, crush injuries, and sharp injuries in preschooler.

A practical and applied approach to assessing the cross cutting nature of child injury prevention as a basis for policy making at the local level

Aim: Risk factors for child injury are multi-faceted. Social, environmental and economic factors place responsibility for prevention upon many stakeholders across traditional sectors such as health, justice, environment and education. Multi-sectoral collaboration for injury prevention is thus essential. In addition, co-benefits due to injury prevention initiatives exist. However, multi-sectoral collaboration is often difficult to establish and maintain. We present an applied approach for practitioners and policy makers at the local level to use to explore and address the multi-sectoral nature of child injury. Methods: We combined elements of the Haddon Matrix and the Lens and Telescope model, to develop a new approach for practitioners and policy makers at the local level. Results: The approach offers the opportunity for diverse sectors at the local level to work together to identify their role in child injury prevention. Based on ecological injury prevention and life-course epidemiology it encourages multi-disciplinary team building from the outset. The process has three phases: first, visualising the multi-sectoral responsibilities for child injury prevention in the local area; second, demonstrating the need for multi-sectoral collaboration and helping plan prevention activities together; and third, visualising potential co-benefits to other sectors and age groups that may arise from child injury prevention initiatives. Conclusion: The approach and process encourages inter-sectoral collaboration for child injury prevention at the local level. It is a useful addition for child injury prevention at the local level, however testing the practicality of the approach in a real-world setting, and refinement of the process would improve it further.

Evaluation of the community involvement of nursing experts in reducing unintentional injuries in children

BackgroundNursing experts regularly visited the community to deliver safety education on the prevention of unintentional injuries in children to the parents of children aged 0–6 years and to pregnant women in a maternity school. This was undertaken to explore the effects of the measure on preventing unintentional injuries in children in Chizhou, China.MethodsUsing the convenience sampling method, the guardians(it means mother in this study)of children were investigated. The nursing experts visited communities in which the number of nursing experts is declining. Data on unintentional injuries in children in the previous year were collected retrospectively.ResultsAfter the nursing experts delivered safety education to the community, the scores of the questionnaire on unintentional injury prevention knowledge completed by children’s guardians increased significantly (p < 0.01). Among the children whose guardians completed the questionnaire, there were 157 cases of unintentional injury in 2020 and 103 cases in 2021 (p < 0.05). The types of unintentional injuries included scratches, falls, sharp object injuries, swallowing of foreign bodies, burns and traffic accidents; there was no statistical difference (p > 0.05). However, there were significant differences in terms of gender ratio and location (p < 0.05).ConclusionIn conjunction with the maternity school for pregnant women and the vaccination programme, nursing experts delivered safety education regarding unintentional injuries in children; this may have promoted safety and protection awareness in the children’s guardians and reduced unintentional injuries.

Technology of combination of physical exercises and poems about nature for integral development physical fitness and cognitive possibilities children of preschool age

Purpose of this work is to highlight the features of the author's systems of integral development of preschool children. Material and Methods. A system of lessons with newborns and infants with the help of dynamic exercises has been developed, as well as an author's system of lessons with children from 1 to 7 years old. The exercises are performed with verses about nature. Results. The use of dynamic gymnastics for newborns and infants "Miracle of Nature" helps to strengthen the musculoskeletal system and all body systems; development of strength, flexibility, agility, endurance, and later - speed; prevention or reduction of child injuries during the subsequent development of walking, running, jumping, etc.; increasing resistance to adverse environmental influences; formation of a base for the tolerance of intellectual workloads associated with studies; creating a solid foundation for subsequent practice of any sport. Conclusions. It is shown that performing exercises not counting, but under poetic images, which is most acceptable for children from 1 year old, promotes integral development, reduces the feeling of fatigue, saturates emotionally classes, making gymnastics very attractive for children and adults.

Pediatrik Maksillofasiyal Travma: 2015-2020 Yılları Arasında Epidemiyolojik Çalışma

Maxillofacial trauma is the most common type of trauma and is an important cause of high morbidity and mortality. Emotional traumas occur in children due to sequelae caused by injuries and the rest of their lives are negatively affected. The aim of this study is to investigate the etiology, epidemiology, and injury type of pediatric maxillofacial traumas, and to make recommendations to prevent child injuries. This descriptive retrospective study was conducted in a regional tertiary hospital. The medical records of all maxillofacial trauma-related admissions to the emergency department between January 2015 and February 2020 were retrospectively reviewed. Etiology of trauma, demographic characteristics, type of trauma, accident type, injury site, administered treatments, and mortality were recorded. 1029 patients aged 4 months-18 years (mean 77.67±59.21 months) including 288 females (28%) and 741 males (72%) were included in the study. Most of the patients (n=390, 37.9%) were in the 13-18 age group. The vast majority of the study population lived in the urban area (n=753, %73.2). Most injuries were seen in the summer (n=438, %42.6). After head+cervical injuries, upper extremity injuries (n=171, %16.6) were the most common and thoracic injuries (n=69, %6.7) least. 57 (5.5%) patients were required hospitalization and the mortality rate was 1.2% (n=12). Pediatric maxillofacial traumas occur mostly in the male gender, in summer, in urban areas, and due to motorcycle accidents. In order to reduce child maxillofacial traumas, public awareness should be increased and playgrounds suitable for all age groups should be created.

The shape of the New Zealand child injury prevention workforce

ObjectiveTo describe the characteristics of the New Zealand child injury prevention workforce and the organisations they represent. MethodsRepresentatives of organisations on the Safekids Aotearoa database were invited to complete an online survey. The standardised questionnaire asked for information about injury prevention focus and expertise, communication preferences and information access. ResultsOf 196 respondents, the majority were female and identified as New Zealand European. For only a small proportion of respondents, child injury prevention is the main focus of their role. The key sources of child injury data and injury prevention information identified was Safekids Aotearoa, followed by the Ministry of Health. Respondents indicated that they would like to receive information on new research, training opportunities and upcoming events, and information from other organisations. ConclusionsMales and people of Pacific and Asian ethnicity are under‐represented in the New Zealand child injury prevention workforce in New Zealand. The low engagement of the sector with Māori authorities is of concern, given the inequities in rates of child injury that exist. Implications for public healthThere is a need to conduct a wider and more regular audit of the child injury prevention sector to determine its composition and identify areas of concern.

Implementation of health promotion in prenatal care at a public health service in Brazil

Prenatal care is the assistance to women throughout pregnancy, birth and puerperium which is an important tool of primary care in the prevention of maternal and child injuries. Prenatal care programs must be horizontal and multidisciplinar according to Ministry of Health's protocols in order to achieve improvements in maternal and child morbidity and mortality indicators. This study is an original interventional project that occurred at a public primary care service in a town of Bahia, Brazil. It was noted some aspects that could be adapted to the Ministry of Health protocols such as shared appointments based on scientific evidence, introduction of prenatal dental care and education actions carried out in a multidisciplinary way. All strategies were implemented in the prenatal care using very low cost tools such as conversation wheels and physical activity schedule. Conversation wheels between pregnant women and caregivers are included in the health humanization policy in Brazil. They are strategies for permanent education in health. Conversation wheels aimed to valorize pregnant women and their life experience in order to build an environment rich in learning and approached them to the health service. The encouragement of physical activity promotes well-being, a sense of belonging and improvements in risk factors for prevalent diseases during pregnancy. Continuing education promotes autonomy's pregnant women. Finally, the involvement of primary care professionals who address different aspects of health promotes co-responsibility and commitment to the adequacy of services offered to the population. The integration of health prevention and promotion actions should be seen as a stimulus to build relationships of trust and bond between users, managers and health professionals. Thus, the implementation of primary care actions during pregnancy expands the woman's connection with the health service at this stage of life and can contribute to better maternal and neonatal outcomes.

Is It Safe to Stay at Home? Parents' Perceptions of Child Home Injuries during the COVID-19 Lockdown.

The COVID-19 pandemic and stay-at-home regulations have increased child home injuries. This study illustrates the type and frequency of child home injuries in Greece during the COVID-19 lockdown. Moreover, the survey reports the results on parents’ proposals regarding child injuries at home during the COVID-19 quarantine. A community-based, cross-sectional, descriptive study was conducted from November to December 2021 in Greece. Parents were asked to voluntarily complete an anonymous questionnaire, designed for the needs of the research. A statistical analysis of the data was performed using the Kolmogorov–Smirnov and Shapiro–Wilk tests for a normal distribution, a chi-squared (χ2) test to compare percentages among different groups and a non-parametric Mann–Whitney U test to determine the differences in Likert scale variables between two groups. A total of 130 parents with at least one child were questioned through an online questionnaire survey. Of the parents, 39.3%, stated that the number of accidents in their home increased. The most frequent accidents were injuries (49.3%). Most of the accidents occurred inside the house (75.8%) and were observed among children aged 0–4 years. A high percentage of children’s accidents was observed in rural/island areas or in the suburbs. Children who were with either their father or mother had one accident, and a higher number of accidents occurred when the children were with their grandparents, with the nanny or alone. For those parents who had difficulty supervising their child, child accidents increased compared to parents who had the ability to supervise. It was noticed that parents who knew how to provide a safe home stated that the number of accidents remained the same. Parents must organize a safer home. Authorities should educate parents on child injury prevention and provide them with financial facilities to provide a safer house.

Childhood injury prevention: Where we've been and where we need to be

Injury remains the leading cause of death for children and adolescents in the US, and firearm injury has overtaken motor-vehicle crashes as the leading mechanism in the US since the topic of injury prevention was last reviewed in this journal. The success of injury prevention efforts relies on multidisciplinary collaboration, and pediatric surgeons play a central role as clinicians who provide and coordinate the care for injured children, as trauma program leaders, and as advocates for children's health and safety. This review will provide a concise history of injury prevention in the US and highlights three areas where pediatric surgeons have an opportunity to impart impactful change in their communities that could lead to lower injury rates.

Demographic Evaluation of Pediatric Medico-Legal Cases in Casualty

INTRODUCTION- Pediatric medico-legal cases are important public health problems in the pediatric casualty in India. These cases are among the leading causes of pediatric disabilities and deaths. We conducted a study to evaluate the demographic features of the medico-legal cases who presented to our pediatric casualty.METHODOLOGY- : In a total of two year study period, 120 patients were presented in casualty as medico-legal cases. Information about the patients was obtained from hospital records and analysed by us from casualty. RESULTS- : 70 male (58.3%) and 50 female (41.6%) patients were included in our study. The majority of the patients were between 10- 14 years of age (n=30; 25.0%). Fall from height was the major complaint (n= 60; 50%) of our patients. Winter was the most common season (n= 37; 30.6%) and January (n=13; 11%) was the most common month for medico-legal admissions. The majority of the patients (n=42; 35%) presented to our emergency room between 18-24 hours. 78 cases (65%) had health risks at the time of presentation. Conclusion: Developing effective &amp; preventive strategies is essential to prevent child injuries. Majority of cases were males and adolescents. There is an urgent need to focus more on this vulnerable age group i.e. adolescent age group. There should be increased awareness among pediatricians about these medico legal cases and improving counselling skills to handle relatives of patients.

Effects of the "FIFA11+ Kids" Program on Injury Prevention in Children: A Systematic Review and Meta-Analysis.

FIFA11+ Kids is a warm-up program specially designed to prevent football injuries in children. This systematic review and meta-analysis aimed to summarize the effects of FIFA11+ Kids on injury prevention in young football players. PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure were searched from 1 January 2016 to 24 August 2022. The primary outcome was overall injuries, and the secondary outcomes were severe, ankle, knee, and lower extremity injuries. Risk ratios (RRs) were calculated for each outcome. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. A total of 230 articles were screened, 6 of which were finally included in the meta-analysis. Compared with normal warm-up training, FIFA11+ Kids significantly reduced overall injury risk (RR = 0.52 [95% CI, 0.44–0.62]; p < 0.00001), severe injury risk (RR = 0.33 [95% CI, 0.18–0.61]; p = 0.0004), lower extremity injury risk (RR = 0.51 [95% CI, 0.41–0.65]; p < 0.00001), knee injury risk (RR = 0.45 [95% CI, 0.29–0.72]; p = 0.0009), and ankle injury risk (RR = 0.56 [95% CI, 0.35–0.89]; p = 0.01) in young football players. FIFA11+ Kids was found to be an effective approach to decrease the injury risk among young football players, which is worth generalizing extensively.