Using VPS Outside the Walls of the PICU

Kosair Children’s Hospital 267 bed hospital which serves as the primary pediatric teaching facility for the University of Louisville School of Medicine Level 1 Trauma designation 26 bed PICU Magnet hospital PICU is a Silver Beacon unit VPS participant since admissions per year

Original Objectives 2001 Educate health care providers Educate the general public Educate the judicial and legislative branches of the government

TEN-4 BRUISING RULE ANY bruising of the TORSO EARS or NECK in a child 4 years of age or younger OR ANY bruising, ANYWHERE, on a child 4 months of age or younger Pierce et al. Bruising Characteristics Discriminating Physical Child Abuse From Accidental Trauma. Pediatrics. December 2009.

House Bill 250 Education of all nurses, day care providers, CPS workers, EMS personnel and others about Pediatric Abusive head trauma. Norton Healthcare birthing centers were to start mandatory education concerning “crying babies” and “shaking babies” It was passed (barely) and signed into law.

Commitment Statement Reserve:

2014JANFEB MARAPRMAYJUNJULAUGSEPOCTNOVDEC2014 Totals # TRAUMA PATIENTS # INFECTIONS Delay in diagnosis # VENTILATED PATIENTS # VENT DAYS # EXTUBATIONS W/IN 24 HRS # REINTUBATIONS W/IN 24 HRS # UNPLANNED EXTBATIONS # DVT MLS IN DAYS AVERAGE PIM 2 MORTALITY SCORE ACTUAL MORTALITY RATE0% 4%0% 6%0% 1% # NAT # NAT DEATHS Transport run sheet in EMR Total # of Transports

Partnership to Eliminate Child Abuse Partners throughout Kentucky and Indiana Consistent messaging Dissemination of Information Education and Awareness

Child Fatality and Near Fatality External Review Panel 2013 is the first annual report The General Assembly enacted KRS which created this panel and it was signed into law by Governor Steven Beshear in our lobby

IMPACT I nformed M others P revent A bused C hildren T oday…Tomorrow…Together

PICU Non-Accidental Trauma

TEN-4 Bruising Rule Patients are being seen earlier due recognition of bruising as a early sign of physical abuse Interventions and care contracts are making a difference. Prospective study that is funded by National Institute of Health

Health Care Provider House Bill 157 passed into law for all healthcare providers who see children are required to take CME for Pediatric Abusive Head Trauma Science of bruising Monthly abusive head trauma conference Residents rotate with Pediatric Forensics TEN 4 pocket card was developed by residents

2015 Public Education Hope for Tomorrow video to all Birthing Centers in Kentucky Price is right Spanish version is coming Commitment statement after viewing

Research Plans Kentucky Children’s Hospital to begin using VPS Multi center trauma study Look at areas that have initiated “Hope for Tomorrow” Look at injuries caused by unrelated caregivers

2015 Kentucky is #1 in Basketball

Child Abuse Deaths In 2005 Kentucky was ranked #1 among the 50 states for child abuse deaths 2013 data from the Child Maltreatment Report done by the United States Department of Health and Human Services Kentucky now ranks #22