Emergency Physicians’ Knowledge and Provision of Child Passenger Safety Information

Abstract

Objectives: While physicians provide discharge instructions to patients and families following emergency department (ED) visits, injury prevention information may not be routinely included in these instructions. This study assessed emergency physicians' knowledge and provision of child passenger safety (CPS) information to patients following motor vehicle crashes (MVCs).Methods: This study was both a survey of emergency physician knowledge and provision of CPS information and an examination of frequency of CPS information in discharge instructions at a single institution. Members of the American Academy of Pediatrics (AAP) Section on Emergency Medicine were invited to participate in the survey. Respondents were asked about their provision of CPS information to patients and knowledge of national AAP CPS recommendations. The institutional ED medical record chart review assessed the frequency of written CPS information for patients of MVC-related visits who were discharged home.Results: There were 317 survey respondents from 1,024 eligible physicians, of whom 43 began but did not complete the survey. The data analyzed are from the 274 who completed the survey. While 85% (95% confidence interval [CI] = 81% to 89%) of physicians believed that CPS information should be included in discharge instructions, only 36% (95% CI = 31% to 42%) correctly answered all knowledge questions. Of the 51 self-identified division ⁄ department chiefs, 15 (29.4%; 95% CI = 16.9% to 41.9%) reported that their EDs routinely provide CPS information in discharge instructions for pediatric passengers in MVCs. For the medical record review, of the 152 randomly selected MVC visits, 13 (8.6%; 95% CI = 4.1% to 13.0%) had documented CPS information in the discharge instructions. Patients with documented CPS information were younger, but there were no significant differences in race, sex, or maximum abbreviated injury scale score between patients with versus without CPS information. Conclusions:While emergency physicians value the use of CPS information in discharge instructions following MVCs, they do not have adequate knowledge of, nor do they regularly disseminate, this information.

Rural–urban differences in health care provider child passenger safety anticipatory guidance provision

“…Training resources which are accessible by all HCPs include CPS courses offered by the AAP. Continuing education related to CPS is important for HCPs to maintain current knowledge levels and stay current on recommendations about CPS (Zonfrillo et al, 2011). Future research in this area should focus on frequency and efficacy of current training provided to HCPs related to CPS issues.…”

Availability of Child Passenger Safety Resources to Emergency Physicians Practicing in Emergency Departments Within Pediatric, Adult, and Nontrauma Centers

“…Although low, respondents to this survey indicated greater provision of car seat information in ED discharge instructions than reported in a prior survey of pediatric ED chairs and division chiefs, where less than one third reported providing discharge instructions containing pediatricspecific child passenger safety topics. 18 Even though there are currently no requirements for the distribution of child passenger safety information from the ED, it would be reasonable to expect all families discharged following an MVC would receive accurate information regarding when to replace child safety seats and restraint use recommendations that are consistent with the current national guidelines for child passenger safety. 29Y31 Further gains in the number of parents who receive child passenger safety information at ED discharge may be realized through the implementation of electronic medical record systems that allow for standardized, computerized discharge instructions.…”

“…13Y16 Currently, ED visits represent an underutilized opportunity to provide parents with recommendations for optimal child passenger safety. 17,18 The ED also could link parents to community child passenger safety resources at a time of potentially heightened awareness of the importance of child passenger restraints.…”

“…13Y16 Currently, ED visits represent an underutilized opportunity to provide parents with recommendations for optimal child passenger safety. 17,18 The ED also could link parents to community child passenger safety resources at a time of potentially heightened awareness of the importance of child passenger restraints.In this subanalysis of a data collected from a national mailed survey of emergency physician attitudes and practices related to child passenger safety, 19 we sought to understand emergency physician awareness of and referrals to ED/hospital and community child passenger safety resources, such as child safety seat installation programs. Pediatric trauma centers address the unique needs of children in terms of both injury treatment and injury prevention.…”

Emergency physicians as human billboards for injury prevention: a randomized controlled trial

“…Less than 30% of ED chiefs reported their EDs routinely gave child passenger safety instructions to pediatric motor vehicle collision (MVC) patients and only 8.6% of pediatric MVC charts had documented safety discharge instructions. 24 Macy et al found that while 95% of pediatric emergency physicians and 82% of adult emergency physicians felt that it was their role to educate parents on child safety practices, less than half gave proper injury prevention advice in hypothetical clinical scenarios. 25 Even when a department is involved in some injury prevention activities, many ED physicians and staff feel this is not enough.…”