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Objective: While national car seat usage is up, children continue to ride unrestrained, especially in the South. Additionally, the percentage of caregivers who have difficulty with a correct installation remains high at 75-85%. This article reviews the child passenger safety program run by The Safety Source-Injury Prevention Service at Children's Medical Center Dallas and reports on the 2013 car seat use and misuse data found at their inspection stations. Methods: For each child seat inspected in 2013, a technician completed the Safe Kids Worldwide Child Passenger Safety Checklist. Researchers reviewed 530 forms and extracted specific data points. Results: Of the children present, 78.6% were riding incorrectly or arrived unrestrained. The majority of seats had more than one error. Errors were significantly related to the type of car seat, with children in infant carriers almost 5 times more likely to be in an improperly installed seat. The most common error was with the harness, followed by using the seat belt to anchor the seat. Nearly all children were in the right seat for their age and weight however, about 6% of children graduated to the next seat prematurely. Conclusions: Despite advances in educating caregivers about proper installation with an increased focus in social and print media, our findings mirror long-standing national installation error rates of over 75%. Quantitative findings narrow down key areas of concern, such as difficulty with the harness and issues of premature car seat graduation, which can then be addressed using a mixed-methods approach. [ABSTRACT FROM AUTHOR]

Our 35-bed acute care pediatric hospital with a specialization in therapy and rehabilitation services experienced an outbreak of norovirus. We describe the measures implemented to prevent secondary transmission. Once laboratory testing confirmed that norovirus was responsible for the outbreak, additional cases were identified using clinical criteria of either abrupt onset of vomiting followed by diarrhea, or acute diarrhea without vomiting. In total 38 staff members, 14 patients, and 5 family members were affected over a period of 17?days. All patients, whether symptomatic or not, were placed on contact precautions. New admissions were postponed and visitor restrictions were implemented. Only soap and water was used for hand hygiene. The environmental disinfectants were confirmed to have Environmental Protection Agency kill claims for norovirus. Cleaning was done three times daily on high-touch surfaces, patient rooms, hallways, bathrooms, and staff work stations. Supplemental ultraviolet light disinfection (UVD) was deployed. Congregating in the cafeteria was discouraged by providing meals to patients and families in their rooms. We eliminated group activities in common spaces. Staff were instructed not to share food and to utilize disposable lunch containers. Symptomatic staff were furloughed for 48 hours; food handlers were furloughed for seven days. Auditing by infection prevention was initiated to assess personal protective equipment (PPE) use and hand hygiene. Measured compliance with PPE use was 96% and with hand hygiene was 95%. While the route by which infection was introduced was not identified, factors that may have contributed to the spread of disease include: sharing of food among staff, close contact during therapy, hardiness of norovirus in the environment, and low infectious dose. Lessons learned include: importance of frequent environmental cleaning, ensuring disinfectants have norovirus kill claims, staff understanding precautions and having one staff member dedicated to UVD. [ABSTRACT FROM AUTHOR]