Abstract
Objectives
To assess the performance of the Canadian Hospitals Injury Reporting and Prevention Program’s newly developed self-harm surveillance tool (CHIRPP-SI) designed to improve emergency department (ED) hospital surveillance of youth self-inflicted injury (SI).
Methods
This was a prospective, single-centre cohort study from February 2015 to September 2015. Eligible participants were aged 6–17.99 years and presented to the ED with a primary mental health complaint. The frequency of SI cases was extracted from three data sources (CHIRPP-SI, medical chart, and the National Ambulatory Care Reporting System Metadata (NACRS)). Cohen’s kappa statistic was used to examine the level of agreement between data sources.
Results
Of the 250 participants who received a medical chart review, 70 completed the CHIRPP-SI. Of those who did not complete the CHIRPP-SI, 86% (n = 154) reported no SI related to their presentation, 12% (n = 22) declined to participate without specifying self-injury status, and 2% (n = 4) were unable to be interviewed prior to discharge. The three sources of surveillance data varied considerably; the medical chart captured the highest frequency of individuals reporting SI related to their ED visit (33.6%), followed by the CHIRPP-SI (28.0%), and the NACRS database (8.4%). The CHIRPP-SI captured the method of SI and the place of occurrence in 100% of individuals, and the bodily location harmed in 98.6% of individuals.
Conclusions
Study findings highlight the disparity between different sources of data, in relation to the capture of paediatric SI, presenting to hospital EDs. If greater details of SI events are to be identified, surveillance tools such as the CHIRPP-SI should be considered.
Résumé
Objectifs
Évaluer la performance de l’outil du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (SCHIRPT-BAI) pour améliorer la surveillance des blessures auto-infligées (BAI).
Méthode
Étude de cohorte prospective menée en 2015. Les participants admissibles étaient âgés de 6 à 17,99 ans et se sont présentés au service des urgences avec une plainte de santé mentale. La fréquence des présentations avec des BAI a été extraite de trois sources de données (SCHIRPT-BAI, dossier médical, système national d’information sur les soins ambulatoires (SNISA)). Le kappa de Cohen a été utilisé pour examiner l’accord entre les sources de données.
Résultats
Des 250 participants qui ont reçu une revue du dossier médical, 70 avaient complété le SCHIRPT-BAI. De ceux sans SCHIRPT-BAI, 86 % (n = 154) n’ont déclaré aucune BAI, 12 % (n = 22) ont refusé de participer et 2 % (n = 4) n’ont pas pu être interrogés avant leur décharge. Les trois sources de données varient considérablement; le dossier médical a saisi le plus grand nombre de personnes ayant signalé une BAI liée à leur visite (33,6 %), comparé à 28,0 % par le SCHIRPT-BAI et 8,4 % par le SNISA. Le SCHIRPT-BAI a saisi la méthode du BAI et le lieu de l’événement pour 100 % des individus, et l’emplacement de la blessure corporelle pour 98,6 % des individus.
Conclusion
Il existe une disparité entre les différentes sources de données quant à la capture des BAI pédiatriques au service des urgences. Le SCHIRPT-BAI pourrait être utilisé pour capturer de plus amples détails à propos des cas de BAI.
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Funding
Funding for this study was provided by the Public Health Agency of Canada (PHAC).
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R. Skinner and S. McFaull are employees of PHAC. The other authors declare that they have no competing interests.
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The study received hospital Research Ethics Board Approval (CHEOREB#15/113X). All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Johnson, D., Skinner, R., Cappelli, M. et al. Self-Inflicted Injury-Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP-SI): a new surveillance tool for detecting self-inflicted injury events in emergency departments. Can J Public Health 110, 244–252 (2019). https://doi.org/10.17269/s41997-018-0139-1
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DOI: https://doi.org/10.17269/s41997-018-0139-1