Injury Reporting

Excessive paperwork is a burden, and no one enters the childcare field wanting to fill out forms. Completing forms often seems pointless and intrudes on busy schedules, taking time away from caring for children. For that reason, injury reporting may be neglected or forgotten, despite the fact that it is an important way to improve childcare programs.

Injuries in Childcare

No matter how careful you are in planning your environment and supervising children's activities, injuries still occur. Types of injuries that often occur in childcare are:

• Minor injuries such as cuts, scrapes and bruises.
• Severe injuries such as head injuries, broken bones, internal injuries, dislocations, or dental injuries.
• Poisoning.
• Drowning.
• Burns.
• Choking, suffocation, and strangulation.

Falls are the leading cause of serious injuries, with most injuries occurring on the playground.

Injury Reporting

Injury reporting means keeping track of the injuries that happen in your childcare program. The information should be kept in the child's file and in your program's injury log. In addition, a copy should be given to the parents of the injured child, and a copy sent to your state licensing agency, as required. In the case of suspected child abuse, you also will need to file a report with your local Child Protective Services agency.

Every childcare facility should have a form for reporting injuries. The form should include basic information about the child such as name, sex, and age; a description of the injury and the incident that caused it; and the treatment provided. It should be signed by both a staff member and the parent of the injured child.

What to Report

Within your own childcare program, record any injury that requires first aid, such as a bandage or a cold compress.

State licensing agency requirements for reporting injuries are different in each state, so contact your state licensing agency to find out what you are required to do. In general, most states require that childcare facilities report injuries that require medical treatment beyond first aid.

Some childcare providers worry that by reporting injuries, and especially by keeping track of them on forms, you will get into trouble. You may fear that by giving parents a form describing the injury, they will bring too much attention to what might have been a minor incident. You also may worry that by reporting injuries to their state licensing agencies, you will look careless or negligent.

In reality, both parents and state licensing personnel know that children are active and no amount of child proofing and supervision can prevent injuries entirely. Planning for injuries and reporting them--and eliminating hazards or conditions that cause injuries, shows you are responsible, not that you have made mistakes. Reporting injuries should be part of your overall plan to keep children safe while they are in your care, along with other safety measures such as covering unused electric outlets, keeping sharp objects out of reach, and having appropriate fall surfacing under playground structures.

Injury Patterns

By recording injuries that happen in your childcare program, you can look for patterns caused by hazardous conditions and identify problem areas before they cause serious injury. For example, if a tree root has cracked and raised the cement in your playground, children may trip over the cement every few days, causing a series of scraped knees and elbows. By tracking these injuries with a reporting form, you will notice that they happen in the same area, which can lead you to investigate and repair the problem before a more serious injury occurs, such as a broken tooth.

In this same way, reporting injuries to your state licensing agency helps all childcare programs improve safety. When statistics on injuries are compiled by a central source, health care researchers can see trends in injuries. For example, researchers may notice that a certain type of playground equipment causes more injuries than other equipment. In that case, they can alert all childcare programs and prevent further injuries. If no one reports injuries, then the same type of incident may continue to occur in other programs. Even one reported injury, if it is severe, can be enough to start a recall.

Through injury reporting, you also may notice if a particular child is having repeated accidents or injuries. This may be a cue that the child has a problem such as improper foot positioning, balance difficulties, or vision issues that should be investigated by the child's physician.

Staff Injuries

Reporting staff and adult injuries is equally important. Staff deserve a safe and healthy work environment, and reporting injuries will help program directors to correct problems sooner. In addition, the Occupational Safety and Health Administration (OSHA), requires occupational health exams for injuries and claims. The most common injury of childcare workers is back injury, usually caused by lifting children, uncomfortable work surface heights, and other correctable causes. If a staff member hurts her back while changing diapers, perhaps the height of the changing table should be considered. If a staff member's back hurts because he has been sitting on the floor reading to children without a back support, a chair could solve the problem.

Injuries Outside of Childcare

In general, you only report injuries to children if they happen while they are in your care. The exception is if you suspect a child is being physically or sexually abused or neglected. In this case, you are required by law to immediately report your suspicion to the local child protective services agency, no matter where the abuse may have occurred.

If you notice a child has an injury when he or she arrives for childcare, ask the parents what happened and note the injury in your injury log. This will help protect you legally. Also, tracking repeated injuries outside of your care may identify medical problems, neglect, or abuse.

Communicating with Parents

Inform parents about injury reporting procedures when they enroll their child in your program. Show them the injury reporting forms and let them know that you will document any injuries, no matter how minor. Explain how this helps you improve your childcare program and catch potential problems early. Parents will be reassured that you are prepared and therefore will not be surprised later to see an injury report if their child does get hurt.

Eva Guralnick, California Childcare Health Program

INTERNET RESOURCES

Sample Injury Reporting Form, www.childhealthonline.org

Healthy Kids, www.healthykids.us

National Center for Injury Prevention and Control, Mailstop K65, 4770 Buford Highway NE, Atlanta, GA 30341; 770-488-1506; www.cdc.gov/ncipc

National Resource Center for Health and Safety in Child Care, UCHSC at Fitzsimons, Campus Mail Stop F541, PO Box 6508, Aurora, CO 80045-0508; 800-598-KIDS; nrc.uchsc.edu

National Safe Kids Campaign, 1301 Pennsylvania Ave. NW Suite 1000, Washington, DC 20004, 202-662-0600; www.safekids.org

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