The death of a child is one of the most painful experiences a parent can endure. Communicating and meeting the needs of parents during this time of crisis is a challenge for nurses. Pediatric intensive care unit and emergency department nurses who may feel overwhelmed and inadequate when working with grieving families, especially with a sudden and unexpected death, are assisted by "The Patterns of Your Life: A Comprehensive Pediatric Bereavement Program." The program is a blending of critical pathways (an element of managed care), educational resources, and family follow-up for 1 year. Preliminary evaluations indicate that the comprehensive bereavement program appears to have many benefits for families and health care staff alike.
Patients managed with upper limb cast immobilization often seek advice about driving. There is very little published data to assist in decision making, and advice given varies between healthcare professionals. There are no specific guidelines available from the UK Drivers and Vehicles Licensing Agency, police, or insurance companies. Evidence-based guidelines would enable clinicians to standardize the advice given to patients. Six individuals (three male, three female; mean age 36 years, range 27-43 years) were assessed by a mobility occupational therapist and driving standards agency examiner while completing a formal driving test in six different types of upper limb casts (above-elbow, below-elbow neutral, and below-elbow cast incorporating the thumb [Bennett's cast]) on both left and right sides. Of the 36 tests, participants passed 31 tests, suggesting that most people were able to safely drive with upper limb cast immobilization. However, driving in a left above-elbow cast was considered unsafe.
Use of safety devices and practices by parents of preschool aged children reported in a face to face interview are generally reliable. Reliability increases if the interview is conducted in the home. Parents may also be more willing to report potential problems if they perceive they may receive corrective assistance.
BackgroundUnintentional injury is the leading cause of death and disability for America’s children. The economic consequences of injury are staggering; with injury being the leading cause of medical spending for children ages 5–14 in Wisconsin. As a health care system, we see the consequences of preventable injuries. As a children’s hospital we have an obligation to lead the way in modelling best practice, evidence-based injury prevention strategies for children in collaboration with our community partners.Methods/approachReview of Wisconsin paediatric injury and death data formed the basis of prioritising program development or system-level strategies for injury prevention. Using a policy, systems, environmental approach, we identified best practice injury prevention strategies with our community partners. By implementing a collective impact model and community engagement, we formulated plans for improving the injury prevention strategies for children and families in our community.ResultsExamples related to child passenger safety, home visitor program, a safe sleep campaign, Safety Town, and a “safety store” will be provided. Program barriers and challenges, as well as successful outcomes in strengthening the culture of injury prevention through community engagement will be shared.ConclusionsHealth care providers and community partners are looking to embrace population health strategies to achieve a greater good for improving the health of children. Using a collective impact model enables communities to accelerate the progress they can have in reducing childhood injury related morbidity and mortality. Safety devices, when correctly used, are highly effective in preventing injuries and saving lives. Recognition of the need to reduce health disparities by removing potential social, economic and language barriers for families around injury prevention strategies is critical.
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