NON-ACCI DE NT AL T RAUMA I N CHI L DRE N RESULTS O F A SC - - PowerPoint PPT Presentation

▶
non acci de nt al t rauma i n chi l dre n
SMART_READER_LITE
LIVE PREVIEW

NON-ACCI DE NT AL T RAUMA I N CHI L DRE N RESULTS O F A SC - - PowerPoint PPT Presentation

Aug 06, 2023 258 likes •424 views

NON-ACCI DE NT AL T RAUMA I N CHI L DRE N RESULTS O F A SC REENING PO LIC Y Je nnife r Wo b ig , RN, Jo na tha n Gro tts, MA Ste phe n K a minski, MD, L ia Ma nfre di, BS E liza b e th T a ylo r-L inze y, RN Santa Bar bar a

slide-1
SLIDE 1

RESULTS O F A SC REENING PO LIC Y

NON-ACCI DE NT AL T RAUMA I N CHI L DRE N

Je nnife r Wo b ig , RN, Jo na tha n Gro tts, MA Ste phe n K a minski, MD, L ia Ma nfre di, BS E liza b e th T a ylo r-L inze y, RN

Santa Bar bar a Cottage Hospital

slide-2
SLIDE 2

BACKGROUND

  • T

BI le a ding c a use o f disa b ility a nd de a th in c hildre n a nd a do le sc e nts

  • Sig nific a nt pe rc e nta g e fro m no n-a c c ide nta l tra uma (NAT

)

  • Ca n g o unre c o g nize d
  • Mo rta lity ra te s a re hig h fo llo wing NAT
  • Survivo rs le ft with se ve re ne uro lo g ic mo rb idity
slide-3
SLIDE 3

BACKGROUND

  • Whe n to sc re e n?
  • Sympto ms a re no n-spe c ific , ha rd to inte rpre t
  • F

inding s o n ima g ing c a n b e mista ke n fo r a c c ide nta l tra uma

  • De c isio n to fo re g o c a n ha ve se rio us c o nse q ue nc e s
  • Ho w to sc re e n?
  • Ske le ta l Surve y
  • Re tina l E

xa m

  • So c ia l Se rvic e s Co nsult
slide-4
SLIDE 4

STUDY PURPOSE

  • E

va lua te the imple me nta tio n o f a NAT sc re e ning po lic y fo r its impa c t o n te st utiliza tio n a nd the ide ntific a tio n o f vic tims o f a b use

slide-5
SLIDE 5

METHODS

  • Sa nta Ba rb a ra Co tta g e Ho spita l
  • L

e ve l I I Pe dia tric T ra uma Ce nte r

  • April 2010 to April 2014
  • 2 ye a rs pre -po lic y (PR) a nd 2 ye a rs po st-po lic y (PP)
  • Pa tie nt se le c tio n
  • I

nc lusio n c rite ria

  • Ag e 0-2
  • Admitte d with skull fra c ture o r I

CH

  • Da ta
  • T

ra uma Re g istry

  • Sa nta Ba rb a ra Co unty Child We lfa re Se rvic e s (CWS) re c o rds
slide-6
SLIDE 6

NAT SCREENING POLICY

slide-7
SLIDE 7

ANALYSIS

  • Pa tie nts c o mpa re d pre (PR) a nd po st (PP)

imple me nta tio n o f the sc re e ning po lic y.

  • Da ta o n a g e , e thnic ity, g e nde r, insura nc e sta tus,

ho spita l L OS a nd e xa ms pe rfo rme d

  • Any po sitive a sse ssme nt finding = Ho spita l

suspe c te d NAT

  • Cro ss-re fe re nc e d with CWS da ta o n CWS re fe rra l

a nd sub sta ntia te d NAT

slide-8
SLIDE 8

RESULTS

slide-9
SLIDE 9

RESULTS

T able 2: Hospital and Pr

  • toc ol Outc ome s

Be fo re Po lic y (n = 46) Afte r Po lic y (n = 38) p-va lue

Hospital L OS (days)

2.7 (2.6) 3.9 (4.4) 0.126

Soc ial Wor k Consult

36 (78.3%) 32 (84.2%) 0.487

Ske le tal Sur ve y

13 (28.3%) 26 (68.4%) < 0.001

Ophthalmology E xam

7 (15.2%) 25 (65.8%) < 0.001

Re c e ive d All Polic y E xams

7 (15.2%) 22 (57.9%) < 0.001

CWS Re fe r r al

12 (26.1%) 17 (44.7%) 0.106

Hospital Suspe c te d NAT

8 (17.4%) 13 (34.2%) 0.128

CWS Substantiate d NAT †

5 (10.9%) 6 (15.8%) 0.365

†Pe r c e ntag e out of hosp suspe c te d NAT NAT : Non- ac c ide ntal T r auma CWS: Child We lfar e Se r vic e s

Ove ra ll Re sults

slide-10
SLIDE 10

RESULTS

Co mpa riso n o f a ll pa tie nts pre -po lic y a nd unwitne sse d po st-po lic y

Compar ison of All Pr e - Polic y (PR) and Unwitne sse d E ve nts Post- Polic y (PP)

Be fo re Po lic y (n=46) Afte r Po lic y (n=35) p-va lue

Re c e ive d All Polic y E xams

7 (15.2) 22 (62.9) < 0.001

CWS Notifie d

9 (19.6) 13 (43.3) 0.026

Hospital Suspe c te d NAT

8 (17.4) 13 (37.1) 0.045

slide-11
SLIDE 11

RESULTS

Pr ivate Insur anc e (n = 33) Se lf- Pay/ Me dic al (n = 51) p- value Re c e ive d All Polic y E xams

8 (24.2) 21 (41.2) 0.106

Hospital L OS (days)

3.2 (3.1) 3.3 (3.9) 0.874

Hospital Suspe c te d NAT 4 (12.1) 17 (33.)

0.023

Co mpa riso n b y I nsura nc e Sta tus

slide-12
SLIDE 12

RESULTS

Non- Hispanic (n = 63) Hispanic (n = 21) p- value Re c e ive d All Polic y E xams

22 (34.9) 7 (33.3) 0.894

Hospital L OS (days)

3.5 (4.1) 2.4 (0.9) 0.045

Hospital Suspe c te d NAT 12 (19.0) 9 (42.9)

0.033

Co mpa riso n b y Ra c e

slide-13
SLIDE 13

DISCUSSION

  • I

mple me nta tio n o f a sc re e ning po lic y inc re a se d utiliza tio n o f dia g no stic to o ls in pa tie nts a g e d 0-2.

  • Othe r o b se rva tio ns:
  • Ra te o f ho spita l suspe c te d NAT

do ub le d

  • CWS sub sta ntia te d NAT

inc re a se d

  • Did no t re a c h sta tistic a l sig nific a nc e in c o mpa ring AL

L pa tie nts PR a nd PP, ho we ve r, did in c o mpa ring a ll PR to unwitne sse d PP

slide-14
SLIDE 14

CONCLUSION

  • We b e lie ve a multi-c e nte r pro spe c tive study wo uld

b e st e va lua te this impo rta nt pro b le m in the future

slide-15
SLIDE 15

THANK YOU

Je nnife r Wo b ig , RN BSN T ra uma Pro g ra m Ma na g e r Sa nta Ba rb a ra Co tta g e Ho spita l 805-569-7575 jwo b ig @ sb c h.o rg