Shaken Baby education in hospitals

[GWL1950]

Following introduction of a simple shaken baby education program for new parents at Children's Hospital of Buffalo and other hospitals in western New York, the incidence of shaken baby syndrome and other inflicted head injuries dropped by 50% (Pedatrics, April 2005).

Seven states now have legislation that requires hospitals to offer new parents the opportunity to watch an educational video that not only discusses the consequences of shaking, but what they can do to help keep their child safe.

In view of the estimate that there are 1400 - 1600 cases of SBS and inflicted head injury that come to medical attention evey year (JAMA, August 2004), and a recent survey of parents indicated that 2.6% self-reported that a child under age 2 in their household had been shaken (Pediatrics, March 2005):

- do you believe that a education program for new parents based on the Buffalo model - which requires 7 minutes of a nurse's time - should be implemented in hospitals?

- do you believe that it is important for a SBS prevention program to focus on education that helps parents protect their child from injury?

- do you believe it is easier to implement a program which educates parents about safety and what they can do to protect their child or a program which educates parents about why they should not shake their baby?

- Do you believe nurses and hospital educators would be more willing to provide information "framed" as "injury prevention" or as "child abuse prevention"?

Info:

April 15 -21 has been designated by the US Senate and 10 states as "Shaken Baby Syndrome Awareness Week 2007"

Upstate NY SBS Prevention Project (Children's Hospital of Buffalo):

- http://www.wchob.org/shakenbaby/

JCAHO article on SBS prevention in hospitals (2006):

- www.wchob.org/shakenbaby/SBS_article.pdf

Other resources, including NY SBS Week and general SBS awareness posters:

- http://www.skippervigil.com/legislate.htm

[justme1972]

I hear these stories and they break my heart...every time I hear them.

I really think that it's a result of mothers not having adequate support...I mean, who would shake a baby if you had someone to come over and give you a break? I'm not saying in any way that it is justified...but when you have someone you can reach out to for help, you are well-rested, well-fed, you can make rational decisions regarding the care of your child. It's terrifying how extreme sleep deprevation plays tricks from yoru mind, and Lord knows I have had to shut the door on my screaming twins, go downstairs, have a good cry, take a deep breath and go back upstairs and try to be a decent mother.

I just think, that without social services assuming that child abuse will take place, that there needs to be a hotline or something that mothers can call, when they feel they are ready to snap...without someone thinking that they need mental health counseling, are bipolar or have emotional disorders.

It's just sad that these situations happen...and I often wonder how many times they could have been prevented if mothers did have someone...anyone that they could call for help.

[Jolie, BSN]

You present compelling evidence that a program of parent education has has a profound impact on reducing the incidence of this type of child abuse. I am all for parent and community education in the form of babysitting preparation, high school health classes, prenatal education, public health campaigns, additions to existing courses such as AHA and Red Cross CPR and First Aid classes, family education on the mother-baby unit, etc., etc., etc......

However, I am not in favor of legislation mandating what nurses must teach to parents (or any patient) in the hospital or clinic setting. While this is well-intentioned, I believe it has the potential to lead us down a slippery slope of well meaning, but ill-informed law makers mandating all kinds of things that may or may not be relevant to a patient's care and education needs, forcing over-taxed nurses to provide care and education that may not be relevant in a given situation. In my experience, the "cookie cutter" or one-size fits all approach to education is almost never the best.

It also raises the issue that parents have the right to refuse any care or teaching during their hospital stay. What if they decline to participate? Does it then become the nurse's or hospital's responsibility if they go home and shake their baby? Would we refuse to discharge parents who choose not to participate in this education?

Again, while I wholeheartedly support this type of education, I believe it needs to be treated in the same manner as other vital aspects of infant care, such as feeding, s/s of illness and infant safety.

[GWL1950]

Jolie wrote -

Again, while I wholeheartedly support this type of education, I believe it needs to be treated in the same manner as other vital aspects of infant care, such as feeding, s/s of illness and infant safety.

Sure, it should be - but it isn't. New parents get lots of info about those other things in their take home books, parenting books (just check the indexes) and magazines, and new baby websites.

They don't get useful info about SBS in hospitals and it clearly does make a difference when they do.

Why? Hospitals don't like the thought of upsetting parents with info about "child abuse", and nurses don't either. So they think it should be given out somewhere - anywhere - before or after hospital. Most parents "pull" safety info - they look for it and welcome it. Most push back when offered "child abuse" info - "why do you want to give that to me?"

And it takes more than sticking a brochure in the take home book. Six months later, 10% of the parents given brochures at our local hospital said they didn't get one, even though the take home book had three (3) different brochures.

And one of the worst things a hospital or nurse can do is to start a prevention program that only educates those parents "who need it."

It would be like only requiring CNE for those nurses "who need it."

[Jolie, BSN]

And one of the worst things a hospital or nurse can do is to start a prevention program that only educates those parents "who need it." Posted by GWL1950 above.

Who suggested that? Perhaps you misunderstood my post. I did not intend to imply that healthcare providers educate only those parents "who need it." I intended to state that healthcare providers should provide individualized education to their patients. That is hardly accomplished by having a nurse spend "7 minutes" on SBS education.

Do I believe that SBS education should be implemented in the hospital setting? YES. There and in the community, high schools, ARC, AHA, public health departments, physician offices, etc. Than can be accomplished thru professional channels (ACOG, AWHONN, AAP, etc.) without the intrusion of legislation. After all, we manage to teach parents the equally important concepts of infant feeding, management of illness, and household safety without legislation requiring it.