Nebraska Injury Prevention and Control News
   Issue #744                               October 2017
In the News
Alone, On Their Back, In a Crib - Helping Babies Sleep Safely
Hospitals Achieve Safe Sleep Champion Status as Part of DHHS Initiative
Lincoln  – There were 45 sudden unexpected infant deaths in Nebraska during 2012 and 2013. The deaths occurred in 16 different counties, covering both urban and rural areas. At least 35 occurred in an unsafe sleep environment.

The Nebraska Department of Health and Human Services (DHHS) worked with the Nebraska Hospital Association, the Nebraska Chapter of the American Academy of Pediatrics, and the Nebraska Perinatal Quality Improvement Collaborative to launch the Nebraska Safe Sleep Hospital Campaign. The campaign provides evidence-based education and training to parents of newborns as well as birthing hospital staff.

“Providing consistent training and education on safe sleep for all hospital personnel caring for children under a year old ensures the same safe sleep message is shared with the parents of more than 26,000 babies born in Nebraska every year,” said Dr. Tom Williams, Chief Medical Officer and Director of Public Health for DHHS. “An increase in safe sleep awareness will result in more babies sleeping in safe environments and reaching their first birthday.”

DHHS is pleased to announce that Mary Lanning Healthcare in Hastings and York General Hospital are the first Safe Sleep Hospital Champions in Nebraska and 30 other hospitals have pledged and are working through the process to become a safe sleep hospital. Learn more about the campaign here .

“It was important for Mary Lanning to become a Safe Sleep Champion because we put a large emphasis on education for our patients and staff,” said Shana Schultz, Director at Mary Lanning Healthcare. “The benefits of having the formal education for the staff and patients allows us to reinforce best practices for safe sleep and helps us achieve the highest quality of care for our patients built on evidenced-based practices.”

“We chose to be a Safe Sleep Champion pilot hospital because we want to provide the safest care possible for our tiniest patients,” said Nancy Hengelfelt, BSN, RN, OB Director at York General Hospital. “Through the initiative our staff has completed Safe Sleep training and models the techniques for our patients. Our new parents see firsthand the proper way to put baby down to sleep, how to dress baby so they aren’t too warm and what a safe sleep environment looks like. It has been beneficial to staff as well as our patients.”

The Safe Sleep Campaign starts within the hospital setting, encouraging all Nebraska birthing hospitals to become a Safe Sleep Hospital Champion. To be considered a Safe Sleep Champion, the hospital signs a pledge, creates or updates a Safe Sleep Policy, provides yearly education to hospital personnel, models safe sleep recommendations, and educates parents with evidence-based safe sleep materials in accordance with Nebraska Revised Statute 71-2103 and the 2016 American Academy of Pediatrics Safe Sleep Recommendations.

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Learn about the hospitals have pledged to become hospital champions and how to become a hospital champion with this tool kit
The ABCs of Safe Sleep:

A  – Your baby should always sleep  alone .
B  – Your baby should always sleep on his or her  back .
C  – Your baby should always sleep in a safe  crib .

Learn more about safe sleep and how to create a safe sleep environment here .

DHHS collaborated with University of Nebraska Medical Center to produce the ABCs of Safe Sleep video that is available to all Nebraska birthing hospitals as well as parents and caregivers.
The video is available in English and Spanish and can be found here .
Increases in United States life expectancy through reductions in injury-related death
Without injury deaths, the average life expectancy at birth in the U.S. could be increased by 1.5 years, according to a report by CDC authors. The report analyzed injury data to understand how reducing injury deaths could impact population health in the U.S.
Key Findings
  • The study found that average life expectancy at birth could be increased by approximately 1.5 years through the elimination of injury as a cause of death.
  • During the period covered by this analysis, the lowest state-specific annualized rate for all injury deaths was 28.6% below the national rate (43.23 per 100,000 population in New York State compared to 60.58 per 100,000 nationally).
  • If the national injury death rate could be brought into line with the lowest state-specific rate, the following would apply:
  • average life expectancy at birth could be increased by 0.41 years
  • an estimated 48,400 injury deaths and $61 billion in medical and work loss costs would be prevented annually.
Review the entire study here .
Safe Kids Nebraska
Fire Prevention Week October 8-14
In a fire, seconds count. Seconds can mean the difference between residents of our community escaping safely from a fire or having their lives end in tragedy.

That’s why this year’s Fire Prevention Week theme: “Every Second Counts: Plan 2 Ways Out!” is so important. It reinforces why everyone needs to have an escape plan. Here’s this year’s key campaign messages:
  • Draw a map of your home by using our grid in English (PDF) or Spanish (PDF) with all members of your household, marking two exits from each room and a path to the outside from each exit.
  • Practice your home fire drill twice a year. Conduct one at night and one during the day with everyone in your home, and practice using different ways out.
  • Teach children how to escape on their own in case you can’t help them.
  • Make sure the number of your home is clearly marked and easy for the fire department to find.
  • Close doors behind you as you leave – this may slow the spread of smoke, heat, and fire.
  • Once you get outside, stay outside. Never go back inside a burning building.
Find more tips here. 
National School Bus Safety Week
Held during the third full week of October each year, National School Bus Safety Week is an active and evolving public education program and an excellent way for parents, students, teachers, motorists, school bus operators, school administrators, and other interested parties - to join forces and address the importance of school bus safety. Designed to promote school bus safety, school districts throughout the country observe School Bus Safety Week.

2017 National School Bus Safety Week:  October 16-20, 2017 and the theme is  " # STOP ON RED!" The theme of National School Bus Safety Week is derived from the Poster Contest the year before. The 2016 winning poster, depicted to the left, was drawn by Branden Pagurayan, Grade 8 at Kapolei Middle School, Kapolei, HI. 

Looking for school bus safety tips all year round? Click here for some great tips from NAPT.
Motor Vehicle Safety
Protect Kids Traveling to and from School
It’s that time of year again! Time to kick off another exciting and fun-filled school year. Even if your kids have already walked out the door for the first day of classes, it is not too late to remind them how to get to and from school safely. Safety must be the first lesson of every new school year.
Tragically, from 2006 to 2015 there were 301 school-age children (18 and younger) killed in school transportation-related crashes. It is important to share a few simple tips with kids to help them stay safe when traveling to and from school.
Find the full article; including safety tips here. 
Teen Driver Safety Week
This week and every week, parents should have conversations with their teens about the important rules they need to follow to stay safe behind the wheel of a passenger car, truck, or SUV. These rules address the greatest dangers for teen drivers: alcohol, inconsistent or no seat belt use, distracted and drowsy driving, speeding, and number of passengers.

THE PROBLEM — TOO MANY TEENS ARE DYING ON OUR ROADS

Motor vehicle crashes are the leading cause of death for teens (15 to 18 years old) in the United States – ahead of all other types of injury, disease, or violence.
In 2015, there were 1,972 teen drivers of passenger vehicles involved in fatal motor vehicle traffic crashes. An estimated 99,000 teen passenger vehicle drivers were injured in motor vehicle traffic crashes.
Parents can be the biggest influencers on teens’ choices behind the wheel – if they take the time to talk with their teens about some of the biggest driving risks, including:
Alcohol: All teens are too young to legally buy, possess, or consume alcohol, however nationally in 2015, almost one out of five teen passenger vehicle drivers involved in a fatal crash had been drinking. Remind your teen that driving under the influence of any impairing substance, including illicit or prescription drugs, could have deadly consequences.
Seat Belts: Wearing a seat belt is one of the simplest ways for teens to stay safe in a vehicle. Yet too many teens aren’t buckling up, and neither are their passengers. In 2015, a total of 531 passengers died in passenger vehicles driven by teen drivers. And 58 percent of those passengers were NOT wearing their seat belts at the time of the fatal crash. Even more troubling, in 84 percent of cases when the teen driver was unbuckled, the passengers were also unbuckled.
Distracted Driving: Distractions while driving are more than just risky—they can be deadly. In 2015, among teen drivers involved in fatal crashes, 10 percent were reported as distracted at the time of the crash. 

Speeding: In 2015, almost one-third (29%) of all teen passenger vehicle drivers involved in fatal crashes were speeding at the time of the crash.
Passengers: Teen drivers transporting passengers can lead to disastrous consequences. Research shows that the risk of a fatal crash goes up in direct relation to the number of passengers in a car. The likelihood of teen drivers engaging in risky behavior triples when traveling with multiple passengers.
Drowsy Driving: Teens are busier than ever: studying, extracurricular activities, part-time jobs, and spending time with friends are among the long list of things they do to fill their time. However, with all of these activities, teens tend to compromise something very important—sleep. This is a dangerous habit that can lead to drowsy driving.

THE SOLUTION — TALK REGULARLY TO YOUR TEEN ABOUT THE DANGERS OF DRIVING

Parents – you’ve guided your teen this far. Driving is a new chapter, a step toward independence for many teens. But your job is not done. Surveys show that teens with parents who set firm rules for driving typically engage in less risky driving behaviors and are involved in fewer crashes. But your kids can’t listen if you don’t talk.
From October 15-21, join parents across the country and participate in National Teen Driver Safety Week .

Get the facts about teen driving and share these statistics with your teen.
Know your State’s nighttime driving restrictions, passenger restrictions, and all the graduated driver licensing (GDL) restrictions, and help enforce them.

Be a good role model for your teen driver and set an example with your own safe driving habits.
Remind your teen that driving is a privilege, not a right, and it must always be taken seriously.
Set the rules before they hit the road.

REMEMBER THE RULES OF THE ROAD

No Drinking and Driving.

Set a good example by not driving after drinking. Remind your teen that drinking before the age of 21 is illegal, and alcohol and driving should never mix, no matter your age. Also remind them that driving under the influence of any impairing substance, including illicit or prescription drugs, could have deadly consequences.
Buckle Up. Every Trip. Every Time. Everyone—Front Seat and Back.
Lead by example. If you wear your seat belt every time you’re in the car, your teen is more likely to follow suit. Remind your teen that it’s important to buckle up on every trip, every time, no matter what (both in the front and back seats).
Eyes on the Road, Hands on the Wheel. All the Time.
Remind your teen about the dangers of texting, dialing, or using mobile apps while driving. Have them make their phone off-limits when they are on the road and turn on the “Do Not Disturb” or similar feature on their phone. Distracted driving isn’t limited to phone use; other passengers, audio and climate controls in the vehicle, and eating or drinking while driving are all sources of dangerous distractions for teen drivers.  
Obey All Posted Speed Limits.
Speeding is a critical issue for all drivers, especially for teens who lack the experience to react to changing circumstances around their cars. Obey the speed limit, and require your teen to do the same. Explain that every time the speed you’re driving doubles, the distance your car will travel when you try to stop quadruples.
Passengers.
With each passenger in the vehicle, your teen’s risk of a fatal crash goes up. Review your State’s GDL law before your teen takes to the road; it may prohibit any passengers in vehicles with teen drivers.
Avoid Driving Tired.
It’s easy for your teen to lose track of time while doing homework or participating in extracurricular activities, so make sure they get what they need most—a good night’s sleep.

PARENTS — KEEP TALKING YEAR-ROUND
Start the conversation with your teen about safe driving habits during National Teen Driver Safety Week , but continue the conversation every day throughout the year.
Even if it seems like they’re tuning you out, keep reinforcing these rules. They’re listening—your constant reminders about these powerful messages will get through.
Get creative! Talking is just one way to discuss safe driving. You can also write your teen a letter, send e-mail or text reminders, leave sticky note reminders in the car, or use social media to get your message across.
Get it in writing. Create a parent-teen driving contract that outlines the rules and consequences for your teen driver. Hang the signed contract in a visible place as a constant reminder about the rules of the road.
If you and your teen are going somewhere together, let your teen drive. Make sure he or she is following the guidelines you’ve set.     
For more information about National Teen Driver Safety Week and safe driving tips for your teens, please visit www.nhtsa.gov/road-safety/teen-driving .
 Older Adult Falls 
Take the Right Steps to Prevent Falls
If you take care of your overall health, you may be able to lower your chances of falling. Most of the time, falls and accidents don't "just happen." Here are a few tips to help you avoid falls and broken bones:
  • Stay physically active. Plan an exercise program that is right for you. Regular exercise improves muscles and makes you stronger. It also helps keep your joints, tendons, and ligaments flexible. Mild weight-bearing activities, such as walking or climbing stairs, may slow bone loss from osteoporosis.
  • Have your eyes and hearing tested. Even small changes in sight and hearing may cause you to fall. When you get new eyeglasses or contact lenses, take time to get used to them. Always wear your glasses or contacts when you need them. If you have a hearing aid, be sure it fits well and wear it.
Submit to the 2017 Falls Free® video and story contest​​​​
NCOA is looking for positive videos of older adults engaged in a variety of falls prevention activities. Each video entry must be accompanied by a brief story that describes it’s falls prevention significance. Contest winners will be awarded prizes and their videos will be used to increase awareness about the impact of falls prevention.

View more photos of the NCOA Falls Free Photo Contest from this year. 

  • Find out about the side effects of any medicine you take. If a drug makes you sleepy or dizzy, tell your doctor or pharmacist.
  • Get enough sleep. If you are sleepy, you are more likely to fall.
  • Limit the amount of alcohol you drink. Even a small amount of alcohol can affect your balance and reflexes. Studies show that the rate of hip fractures in older adults increases with alcohol use.
  • Stand up slowly. Getting up too quickly can cause your blood pressure to drop. That can make you feel wobbly. Get your blood pressure checked when lying and standing.
  • Use an assistive device if you need help feeling steady when you walk. Appropriate use of canes and walkers can prevent falls. If your doctor tells you to use a cane or walker, make sure it is the right size for you and the wheels roll smoothly. This is important when you're walking in areas you don't know well or where the walkways are uneven. A physical or occupational therapist can help you decide which devices might be helpful and teach you how to use them safely.
  • Be very careful when walking on wet or icy surfaces. They can be very slippery! Try to have sand or salt spread on icy areas by your front or back door.
  • Wear non-skid, rubber-soled, low-heeled shoes, or lace-up shoes with non-skid soles that fully support your feet. It is important that the soles are not too thin or too thick. Don't walk on stairs or floors in socks or in shoes and slippers with smooth soles.
  • Always tell your doctor if you have fallen since your last checkup, even if you aren't hurt when you fall. A fall can alert your doctor to a new medical problem or problems with your medications or eyesight that can be corrected. Your doctor may suggest physical therapy, a walking aid, or other steps to help prevent future falls.
Concussion
CDC's Efforts to Improve Traumatic Brain Injury Surveillance
In response to the growing concern about the risk of long-term health effects of traumatic brain injury (TBI) and concussion, CDC is planning to pilot a national household survey to capture information about this prominent public health issue. This special report reviews the current surveillance landscape for TBI and describes how the proposed methodology will address the gaps. Benefits and challenges of the methodology are discussed. Find out more by reading the full article.

This study—a collaboration between researchers at CDC’s Injury Center, and Children’s Hospital of Philadelphia—examined the impact of a 2-part primary care–based intervention. The intervention consisted of: (1) developing a clinical decision support tool referred to as the Concussion SmartSet, or “SmartSet,” available within the electronic health record, and (2) clinician training on current best practices in concussion diagnosis/management and utilizing the SmartSet. Results of the study show that using an electronic clinical decision tool—coupled with in-person training—may be the key to changing primary care provider behavior around concussion care. Find out more by reading the full article.
Prescription Drug Overdose


CVS to Limit Opioid Prescriptions to a Seven-Day Supply to Address Opioid Crisis
In an effort to address the nation’s opioid abuse epidemic, CVS will become the first retail chain pharmacy to limit opioid prescriptions to a seven-day supply for certain conditions. Under its new initiative, CVS will be:

  • Limiting the supply of opioids dispensed to seven days for certain acute prescriptions for patients who are new to therapy;
  • Limiting the daily dosage of opioids dispensed based on the strength of the opioid; and
  • Requiring the use of immediate-release formulations of opioids before extended-release opioids are dispensed.

Additionally, CVS Pharmacy locations will strengthen counseling and educate patients about the Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain, which advises using the lowest effective dose for the shortest duration possible. For patients filling an opioid prescription, pharmacists will counsel patients about the risk of dependence and addiction tied to duration of opioid use, the importance of keeping medications secure in the home, and methods of proper disposal of unused medication.
CVS plans to roll out these initiatives beginning February 1, 2018. "We've got an epidemic on our hands, and we've got clear evidence that, if we restrict access to these medications, more than we're doing so right now, we'll reduce the amount of addiction that occurs, and as a result of that, we'll reduce the amount of human suffering," said Dr Troyen Brennan, chief medical officer for CVS Health, to Today .
 
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Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder
Highlights:

•Adverse Childhood Experiences (ACE) were associated with earlier age of initiating opioid use.
•ACE were associated with recent injection drug use and lifetime overdose.
•About half of respondents experienced four or more of the ten assessed ACE.

Read the full study here . 
Trauma
Generally when people think or hear about trauma, they think about severe motor vehicle accidents, sports injuries and falls. Many don’t think about domestic violence and its involvement in trauma. Domestic Violence comes in all shapes and sizes, including physical, verbal, emotional, financial and psychological actions and threats against another person – man, women or child (Newswire, 2017). Staggering statistics reveal, every 9 seconds in the US a women is assaulted or beaten, it is the leading cause of injury in women – more than car accidents, muggings and rapes combined, and nearly 95% of women who have been physically abused by their partners never contacted anyone for help (Domesticviolencestatstics.org, 2017).
           October is Domestic Violence Awareness Month, its purpose is to raise awareness about abuse. As Injury Prevention Partners and healthcare providers this is an excellent time to raise awareness, review key warning signs, update contacts for resources and GET INVOLVED!
           Below are some resources to assist in your research and awareness regarding this topic:
National Coalition Against Domestic Violence - https://ncadv.org/
National resource Center on Domestic Violence - http://www.nrcdv.org/dvam/home
National Network to End Domestic Violence - http://nnedv.org/getinvolved/dvam.html
Nebraska’s Network of Domestic/Sexual Assault Programs - http://dhhs.ne.gov/children_family_services/Pages/nea_domesticprograms.aspx
For more information please contact Crystal Dailey RN, DHHS Trauma Nurse Specialist 402-722-4300 or crystal.dailey@nebraska.gov
  Safety Observances

Walk to School Day, October 4



Teen Driver Safety Week, October 15-21





Quick Links
Contact Information

Peg Ogea-Ginsburg, MA         
Injury Prevention Program Coordinator  


Jason Kerkman, MPH 
Safe Kids Nebraska Coordinator 


Amy Reynoldson
Prescription Drug Overdose Prevention Coordinator

Jeanne Bietz, MA 
Motor Vehicle Safety Coordinator jeanne.bietz@nebraska.gov

Ashley Newmyer, MPH, CPH
Epidemiology Surveillance Coordinator

Felicia Quintana-Zinn, MS, MBA
Prescription Drug Overdose Prevention Epidemiologist

Celeste Reker, MPH                        
Crash Outcome Data Evaluation Data Analyst  
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