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Effectiveness of a Car Seat Distribution and Training Program

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					NOTE: GRAPHICS WILL BE ADDED FOR THE PRESENTATION ON 4/ 15/08

Numbers Don’t Lie
Program Evaluation: Don’t Skip This Step (OPC) Lifesavers 2008 Presentation 4/15/08 10:15 – 11:45 A.M. Oregon Ballroom 201

Presenter:
Judith (Judy) Hirschfeld, MSA, CPST, Instructor Candidate
Nationwide Children’s Hospital Columbus, OH Judith.Hirschfeld@NationwideChildrens.org 614-722-6503 Others who assisted with research and presentation: Dr. John Hayes, Katy Smith, Lisa Blackwell, Wendi Lowell, Carla Coffey, Jared Stemen

Effectiveness of a Hospitalbased Car Seat Distribution and Training Program

Challenge to determine effectiveness—one option:
• Test knowledge acquired • Develop an effective test • Is knowledge put into practice every time child travels?

Nationwide Children’s Hospital has a unique situation :
1.

Car seat program for over 10 years with a database
–Distribution, 1000 and 2000 seats per year

Nationwide Children’s Hospital has a unique situation :
2. Level 1 Trauma Center with a Trauma Database

Nationwide Children’s Hospital has a unique situation :
3. Primary Care Clinics affiliated with the hospital

Nationwide Children’s Hospital has a unique situation :
4. IRB Approval to compare databases

Nationwide Children’s Hospital has a unique situation :

We are able to evaluate based on performance

Information about Nationwide Children’s Hospital
• • • • • • • Columbus, OH, location Formerly known as Children’s Hospital 6,000 employees 900 doctors 328 licensed beds, 60 off-site leased beds 695,992 outpatient visits Ranked 12th on U.S. News & World Report's 2007 Edition of America's Best Children's Hospitals

Hypothesis:
Children whose parents have received training and appropriate car seats from Nationwide Children’s Hospital will be admitted less often to our hospital due to severe injuries from motor vehicle crashes compared to a control group matched by age, zip code, clinic and date.

Assumptions:
In central Ohio:
• Most children in a MVC will be taken to Nationwide Children’s. • Children rarely or never declared dead at the scene of the crash, but instead brought to the hospital • Low income families are mobile, but usually move within same vicinity

Trauma database at Nationwide Children’s Hospital

Information kept on children receiving seats from the hospital

Our test group:
• Trained by a Child Passenger Safety Technician • Received a car seat that would last at least 2 years • Received seats between 1/1/99 & 6/26/07 • Received seat when they were 2 years of younger

Numbers in our Test Group
• 6,015 children • 3 of those children found in the Trauma Database due to a MVC injury

Control group:

• Number in the control group: 177,968 • 230 appearing in the Trauma Database • Same zip code, same clinic, same period of time, same ages

Test Group vs. Control Group Comparison:
• Using an odds ratio—
– You were 39% as likely to be seriously injured in a MVC if your parents go through car seat training than if they don’t.

Test Group vs. Control Group Comparison:
You are 2.6 times more likely to be seriously injured in a MVC if your parents or caregivers do not go through the car seat program

Chi Square an acceptable method of evaluation

Since the serious injuries are small (about 0.1%) the confidence interval is wide and cannot rule out a chance finding. P=.09

Further research-• Use a larger test group; a larger number of serious injuries • Use a better identifier than name—such as medical record number • Study a larger geographical area • Look at financial aspects of injuries

Injury Pyramid: ―admitted‖ versus ―treated and released‖

Details of three admitted children in the control group
Patient

Type Seat Received

Age at which child admitted for MVC crash 4 years, 2 Days, 33 pounds 6 years 42 pounds

Type Restraint Length of Used hospital stay

Patient A

Convertible (5 to 40 lbs.) Combination seat (20 to 80 lbs.)

Seatbelt rear

12 days

Patient B

None, lap of parent in front seat

One day, pronounced dead

Patient C

Combination seat(20 to 80 lbs.)

4 years, 1 ½ mo’s 42 pounds

Lap belt front 6 days seat

Results suggest Booster Seat Law would be Beneficial

Questions?


				
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posted:11/3/2009
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