Car seat test

Posted

How much teaching are you allowed to do regarding car seats in your unit? For me, we put the baby in it however the parents bring it to us and aren't allowed to say anything to them except, "read the manual." (Which of course none of them do.) I feel like we are letting these babies be completely unsafe and it kills me!

Do any of your units provide car seat education to staff to allow for parent teaching? I would love to have a car seat tech on staff! (Totally dreaming...)

akulahawkRN, ADN, RN, EMT-P

Specializes in Emergency Department. Has 7 years experience. 3,484 Posts

Not a working RN (yet) but I noticed during my maternity rotations that we weren't allowed to test/inspect the car seat for proper installation, probably due to fear of liability reasons. I don't think that many, if any, of the staff were certified in infant car seat installation. I think the most we did was tell them to read the manual for the car and the seat and advise them that they should visit a certified installer. If I recall, around the Sacramento region (for instance) the CHP offices have installers as do some of the fire stations. The "Baby" stores usually have lists of people that are certified to teach/install these seats.

If you could remove the liability fear, it would have been completely awesome to have the appropriate tech do the teaching for infant/child car seat installations. The few times I escorted the new moms out to their car I felt similarly though... not a comfy feeling.

essT

Specializes in NICU. Has 5 years experience. 101 Posts

Our fire department in town does car seat safety checks. We recommend that to parents if they have questions or need help with installation. On discharge, the RN carries the infant to the car in his/her car seat, hands the seat to the parent to put in the car, and writes a note documenting this in the chart on return to the unit. It's absolutely a liability/CYA thing.

NICURN29

Specializes in NICU. Has 11 years experience. 188 Posts

I believe this person is not asking about car seat installation but instead about car seat tolerance tests, which are done on preterm infants to make sure they can safely ride in a carseat. We do some minimal education, but there are a couple of us who have been, in the past, CSTs, and we did some education with the staff on appropriate things to teach. For the most part, we talk to them about how the straps should lie and how tight they should be, as well as the fact that they should be rear-facing until age two. We do ask them to demonstrate for us that they know how to put their baby in the seat for discharge.

thatsthekeyRNC

Specializes in NICU. 194 Posts

We basically can't do anything, although the mom-nurses are more helpful just because they have experience...the parents are supposed to be independent with the car seat at discharge. We do discuss how tight the straps should be and other basic things, but not much. I always try to tell parents close to discharge to get the seat inspected, read the manual, and play around with the seat (I could wrestle with the things for hours trying to move the straps down to actually FIT a newborn baby/premie :-|) because it's their seat and they have to use it. The reality is that I just know we can't help them! Parents have actually yelled at us for not helping them...

Now for the car seat test (tolerance) we do put the baby in the seat ourselves.

NicuGal, MSN, RN

Specializes in NICU, PICU, PACU. Has 30 years experience. 2,743 Posts

The parents are responsible for

moving the straps on the car seat prior to the challenge. We cannot do

anything with the car seat itself and we don't fasten baby in nor do we put the baby in the car. We have a car seat safety video the parents watch in our discharge class but they are responsible for the seat. We have it from legal to not do anything to the seat.

katierobin23

147 Posts

Glad to see its not just my unit :( car seats are such a passion of mine and none of the parents care. We had a baby die in a crash after she had been in our unit because of car seat misuse and still nothing changed. I can't believe we put so much effort into educating parents about everthing else and can't teach them about the single most dangerous situation they put their children in. End rant.

klone, MSN, RN

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership. Has 16 years experience. 14,116 Posts

We weren't supposed to. I did anyway. I could not in good conscience let them drive away with an improperly installed car seat.

Not sure what this has yo do with car seat challenges, though.

katierobin23

147 Posts

Mostly the strap adjustment has to do with the challenge. And just that when they bring it in, it should be a great opportunity to talk about the rest of it but we can't.

babywhisperer333, BSN

Has 8 years experience. 279 Posts

I'm in Canada and we have a number of education pamphlets for families, as well as a video. The families bring in the seat and we make sure that the family is educated in the proper positioning of both the baby, and the straps.We will demonstrate proper technique for them, but they must successfully demonstrate that they can safely put the baby in the seat, as well as manipulate the strap height/ tightness before discharge. On my unit, all premature babies must also pass a 90 minute car seat challenge before discharge- meaning that in the 90 minutes they do not have any ABD's. In order for a baby to be discharged, they have to pass the car seat challenge.

ctabs14, MSN

Specializes in NICU (RNC-NIC) & Informatics (RN-BC). Has 8 years experience. 117 Posts

Are you asking about the actual test, or when baby is discharged and put in the car?

My unit does a 90 minute study as well that the baby must pass before being discharged. We teach parents how to safely put baby in, adjust straps, and secure them. One of our charge nurses is certified in car seat safety, and our other charge nurses and team leads can also verify that the baby is fit properly into the car seat before the study starts.

When the baby is discharged, the parents put the baby in the car seat and puts them in the car. We're allowed to look and make sure everything looks good, but we're not allowed to actually help secure them for liability reasons.

acenab4jc

Specializes in NICU. 17 Posts

We recently had 2 (from our unit) train as car seat techs, and they are available at least once a month on a Monday for the whole hospital and community. I try to refer parents to bring their car seat in on that day (at some point between them becoming less scared of their baby and the rush to get out the door so that they can, hopefully, absorb some of the information).

I make the parents strap the baby in for discharge and will make a comment if the straps are too loose. Usually, we do the car seat tests in the middle of the night, and the parents are not around - we have to move the straps ourselves in order to do the test properly - we should probably get the parents to do that at some point before the test (something to look into).

Maybe you could look into community resources for car seats and see if there are programs for you and some interested colleagues to attend and become certified;) Make sure you look into costs and such. If your hospital is willing to pay for it, you may have to be available to serve the whole hospital, not just the NICU.