Upstate New York Shaken Baby Syndrome Education Program: The Nursing Perspective

1. Upstate New York Shaken Baby Syndrome Education Program:The Nursing Perspective Kim Smith, RN Kathy deGuehery, RN

2. Shaken Baby SyndromeEducation Program Who are we? • We are RN’s with over 50 years combined experience in maternity and pediatrics • We were staff nurses & nurse managers on units in the hospital

3. Shaken Baby SyndromeEducation Program How we became involved in program? • After two years of the pilot project a grant was awarded to expand the program into the next region • We were hired to coordinate this program • Already familiar with program • Believed in program

4. Goals of program: To educate every parent, upon the birth of every child, before leaving the hospital Track success of program through returned commitment statements Confirm a reduction of SBS Shaken Baby SyndromeEducation Program

5. Shaken Baby SyndromeEducation Program How did we expand the pilot program ? • Set-up meeting with nurse manager at each hospital • Need nurse manager support to make program work • Emphasize the importance of staff buy-in !! • This is a totally nurse driven program • Without nurses this program would fail

6. Shaken Baby SyndromeEducation Program Steps to implement program in hospital • Explain components of program • Give options for training staff Nurse coordinator provide in-service vs. nurse manager train their staff • Let nurse manager decide what works best on their unit • Supply unit with educational materials for training

7. Shaken Baby SyndromeEducation Program Arrange for delivery of program materials to hospitals • Determine number of deliveries in hospital per year • Order supplies from vendors • Prepare monthly return envelopes for year • Have supplies delivered to hospitals • Follow–up to ensure hospitals received education materials

8. Shaken Baby SyndromeEducation Program The Nuts and Bolts of the program Guidelines for educating staff How the program is done!!

9. Shaken Baby Syndrome Education Program • Education needed to remind both mother and father at the correct time. • When they are primed to receive information. • When they will soon be exposed to the frustrations of being a new parent.

10. Shaken Baby Syndrome Education Program Educate parents to be advocates to disseminate information to others.

11. Shaken Baby Syndrome Education Program • Give all parents written materials: • AAP ‘Preventing Shaken Baby Syndrome’ leaflet. • SBS information provided separate from other newborn materials.

12. Shaken Baby Syndrome Education Program • Discuss with parents how to cope with a crying baby. • Refer to the AAP leaflet.

13. Shaken Baby Syndrome Education Program • Offer parents opportunity to watch 8 minute video, ‘ Portrait of Promise’ • If parents decline video, they can still participate in the program. • Display poster “ Never, Never, Never Shake a Baby” on nursing unit.

14. Shaken Baby SyndromeEducation Program • Both parents are also asked to sign a commitment statement verifying receipt of the information. • Signed by both parents if possible. • Witnessed by nurse/educator.

15. Shaken Baby SyndromeEducation Program • For tracking purposes send one copy of commitment statement to study coordinator in monthly self-addressed return envelopes • Give other copy to parents.

16. Shaken Baby Syndrome Education Program If parents refuse to participate in the program (by not signing the commitment statement) please educate them about the dangers of SBS and return unsigned form to study coordinators for tracking.

17. Shaken Baby SyndromeEducation Program Who do we reach ? • 35 hospitals • 20 counties • Western 1/3 of New York State • Approximately 35,000 families educated per year ! • This program has educated over 120,000 families since it’s inception.

18. WNY Hospitals: Children’s Hospital of Buffalo Brooks Memorial Hospital (Dunkirk) United Memorial Medical Center (Batavia) Intercommunity Hospital (Newfane) Jones Memorial Hospital (Wellsville) Lockport Memorial Hospital Medina Hospital South Buffalo Mercy Millard Fillmore Suburban Hospital (Buffalo) Niagara Falls Memorial Hospital Olean General Hospital Sisters of Charity Hospital (Buffalo) WCA Hospital (Jamestown) Wyoming Intercommunity Hospital (Warsaw) Mount St. Mary’s Hospital (Lewiston) Westfield Hospital Finger Lake Region Hospitals: 1. Arnot-Ogden Memorial Hospital (Elmira) 2. Nicholas Noyes Hospital (Dansville) 3. Newark-Wayne of Via Health (Newark) 4. Park Ridge Health Systems-Unity Health (Rochester) 5. Lakeside Memorial Hospital (Brockport) 6. Geneva General Hospital 7. F.F. Thompson Hospital (Canandaigua) 8. Schuyler Hospital (Montour Falls) 9. Corning Hospital 10. St. James Mercy Hospital (Hornel) 11. Rochester General Hospital 12. Ira Watertown Region Hospitals: 1. Samaritan Medical Center 2. Carthage Area Hospital 3. Lewis County General Hospital 4. Canton-Potsdam Hospital 5. E.J. Noble Hospital 6. Claxton-Hepburn Medical Center 7. Massena Memorial Hospital Shaken Baby SyndromeEducation Program

19. Shaken Baby Syndrome Education Program • Monitor monthly commitment statement return rate • Notify nurse manager of any changes in compliancy and follow through with corrective action • Post trouble shooting reminders on unit for staff • In-service as needed

20. Shaken Baby Syndrome Education Program A message from the SBS Prevention Program Please remember to ask all parents to sign the commitment statement . If they don’t want to participate in the program, it’s OK. Just remember to fill out a commitment statement and write refused. To have continued success we need at least 75% of commitment statements returned. Thank you for all your help.

21. Shaken Baby Syndrome Education Program Nurse Coordinator Responsibilities • Generate and maintain database of information provided by commitment statements • This information is used for statistical analysis and for tracking purposes • All Commitment statements and database are confidential and kept under lock and key at all times

22. Shaken Baby Syndrome Education Program • Conduct monthly, random follow-up parent phone calls What do parents remember? What works best about the program? Do they share information learned with other caregivers? • Enter this information into database

23. Shaken Baby Syndrome Education Program Nurse Coordinator Responsibilities Identify cases of SBS by communicating with: • Staff from hospitals • County medical examiner • Child mortality review boards • Child protective services • Media outlets

24. Shaken Baby Syndrome Education Program What do we do if there is a suspected case of inflicted head injury? • Assist with information gathering of SBS cases • Cross-reference mother’s name in database to determine if there is a signed commitment statement • Record information to monitor number of cases for tracking

25. Shaken Baby Syndrome Education Program Steps to ensure program’s success

26. Shaken Baby Syndrome Education Program Establish good working relationship with nurse manager. • Initial face to face contact with nurse manager • This gives a face to the program • Need “buy-in” of the nurse manager • If the nurse manager understands the value of the program, then the staff will too! • Monthly phone/ e-mail to maintain open communication

27. Shaken Baby Syndrome Education Program Keep staff interested in program: • Frequent program updates • Quarterly newsletter • Media coverage (news, radio, TV)

28. Shaken Baby Syndrome Education Program Important for coordinator of program to be a nurse. • Can relate to how nurse feels • Understands overwhelming work load • A leader who will interact with and motivate staff

29. Shaken Baby Syndrome Education Program The right approach with parents: • Same message to every new parent • Non-threatening approach • Advocate for child • Relay message to other caregivers

30. Shaken Baby Syndrome Education Program Nurse-Driven Program: • This program is the first to have demonstrated that a parent education program delivered completely by nurses can have a documented impact in significantly reducing SBS. • Nurses are in a unique position to spread the word on SBS to the most important audience at the most critical time.

31. Shaken Baby Syndrome Education Program Key Challenges: • Tendency for others to make this harder than it is • The program works because it is short and sweet • Remember to keep the program simple!

32. Shaken Baby Syndrome Education Program As a result of this program: • Increased awareness of SBS • Decreased incidence of inflicted head injury

33. Shaken Baby Syndrome Education Program New York Times article: May 29, 2001 • Sparked a huge interest in program • Got the word out • Many requests for information • World recognition Good Morning America BBC interview

34. Shaken Baby Syndrome Education Program Legislation: • December 2001: New York State Law mandates that all parents of newborns be given written information about the dangers of infant shaking. • November 25, 2004: New York State Law mandates that all parents of newborns be offered the opportunity to view SBS prevention video prior the discharge from hospital.

35. Shaken Baby Syndrome Education Program • The first 6 years of study results published in the April 2005 edition of the Journal, “PEDIATRICS”. • 2005 Commissioner’s Award for New York State This award is given for outstanding contributions toward the prevention, intervention, and treatment of child abuse and neglect.

36. Parent Comments: • “very informative, a must for first time as well as veteran parents (grandparents and caregivers too!)” • “it opened my eyes to others watching my baby and letting them know about SBS” • “informed parents are the best parents, keep on educating people it will help better our society” • “Great program!!”

38. Shaken Baby Syndrome Education Program The next phase of the program: • Involvement of community physicians • “Booster shot” of educational materials provided at the first doctor’s office visit • Reinforces the message provided at birth • Helps parent cope with infant crying

39. Shaken Baby Syndrome Education Program Upstate New York has shown the world how to prevent SBS !!!!

40. Shaken Baby Syndrome Education Program Thank you for joining the fight to eliminate SBS once and for all. Your compassion and support will save babies’ lives one family at a time !