Handle with care: A nurse’s mission to prevent infant abusive head trauma
For new parents, caring for a crying baby can be very difficult, and often they are not aware of how frustrating it is until they are faced with a stressful situation. Sadly, research indicates that crying is the number one cause of physical abuse of infants, specifically Shaken Baby Syndrome (SBS), also known as abusive head trauma (AHT). Statistics from the National Center on Shaken Baby Syndrome show that every year in the United States at least 1,200 to 1,400 children are shaken, and 25 to 30 percent of shaken babies die. Survivors of shaken baby syndrome often have lifelong complications, including brain damage, seizures, learning disabilities, and blindness.
Kelly Cappos, R.N., B.S.N., C.P.U.R., C.L.N.C., is one of three nurse coordinators for the Pennsylvania Shaken Baby Syndrome Prevention and Awareness Program based at Penn State Hershey Medical Center and Penn State Hershey Children’s Hospital. She and colleagues Carroll Rottmund, R.N., B.S.N., C.C.R.N., C.L.N.C., and Marie Killian, R.N., B.S.N., C.C.R.N., as part of this research-based parent education program, have educated nurses statewide at 111 children’s and birthing hospitals, oversee the office-based program in 16 central Pennsylvania counties and serve as a resource for child abuse prevention efforts worldwide.
The SBS Prevention Program was the brain child of Mark Dias, M.D., F.A.A.P., professor of neurosurgery, vice chair of clinical neurosurgery, and chief of the Division of Pediatric Neurosurgery, Penn State Hershey Medical Center. He began the parent education program in upstate New York in 1998. In 2002, he came to the Medical Center and under his guidance, the team developed his prevention model for education, which is completely nurse driven, into a program now widely recognized and embraced by maternal child health and neonatal intensive care nurses as well as child abuse prevention associations statewide. The program is funded by the Centers for Disease Control and Prevention (CDC) and the Pennsylvania Department of Health. Pennsylvania is the first state in the nation to have 100 percent of hospitals educating parents as per the Dias Model.
“I feel that all I have done as a nurse over the last twenty-nine years was in preparation to be an effective nurse coordinator for this program,” says Cappos, who has worked with the program for over six years. “This position utilizes all of my past nursing experience. It perfectly blends my sincere desire to protect babies with my maternal child health background, legal nurse consulting experience, childbirth education, love of teaching, medical research experience, policy publication development, and my nursing management skills.”
According to Cappos, there are many misconceptions about Shaken Baby Syndrome including that it only happens to babies whose parents are young, poor, inexperienced, and uneducated, but that is not always true. “The main trigger of these injuries is crying, and all babies cry, so all babies and all families are at risk,” she adds.
Therefore, the program educates ALL parents, whether it is their first baby or their fifth, even if they received the education with a prior birth. This reminder, at the time of each baby’s birth, is consistent with the Pennsylvania State Law 2002-176: The Shaken Baby Syndrome Education Act.
“SBS doesn’t have to happen! It’s important to let parents know it’s OK to ask for help when they are tired, stressed, or feel like they may lose it,” Cappos says. “It’s not OK to shake, slam, or throw a baby ever. A momentary lapse of control by a caregiver can lead to a lifetime of serious consequences or even the death of a baby.”
It is very gratifying for Cappos to teach maternal child health nurses that they can make a difference. “Often these nurses break down in tears saying that they were not previously aware of the devastation of infant abusive head injuries,” says Cappos. “The in-services we conduct with obstetric nurses heightens their awareness of the seriousness of Shaken Baby Syndrome. They no longer see this only as a pediatric issue that needs treatment, but as something they can help to prevent.”
The Pennsylvania SBS Prevention Program Nurse Coordinator team was recognized in the Penn State Hershey 2007-2008 Portraits of Caring Annual Report, was nominated for the 2010 Nancy R. Kruger Award for Clinical Scholarship, was a 2010 National Magnet Conference abstract submitter, and was honored for three consecutive years at the Penn State Hershey Annual Nursing Recognition Reception.
In addition, Cappos and her colleagues have presented educational conferences on infant abusive head injuries at the state, national, and international levels to nurses, physicians, attorneys, social workers, childbirth educators, child abuse prevention partners, emergency medicine technicians; nursing, medical and high school students, and parents.
Cappos believes that all of her past experiences, both personally and professionally have made her the nurse she is today, and she is grateful to all those who have been part of this journey. Her parents, who were both in the medical profession, taught her the importance of compassion and service to others at a very young age. As the oldest of four daughters, her mother taught her how to care for her younger sisters. With her family as her inspiration, she developed a love of caring for babies and small children which lead her to become a maternal child health nurse. In addition, her one sister Kathy Ringenbach, R.N., C.C.R.N., has worked at the Medical Center for more than twenty-six years and is the clinical care coordinator for the Trauma Team.
As the parents of three sons, Cappos and her husband Dave quickly learned that the most humbling experience is being a parent. Although their children were never shaken, they do know the heartbreak of having their babies hospitalized in the Pediatric Intensive Care Unit. “My family experienced numerous health challenges, and as a nurse, I gained a deeper understanding of the worry, confusion, and agony families face when their loved ones are hospitalized or critically ill,” Cappos states.
Cappos adds that the most rewarding part of her job is believing that they may prevent serious injuries or even death to infants by educating their parents. “We’ll never know how many babies we’ve saved, but we do receive calls from pediatricians who report that their new parents say they remembered the education when they were up in the middle of the night with their crying baby. That’s when we get big smiles on our faces hearing that parents really did get the prevention message and applied it at the appropriate time!”