Safety is a top priority of childcare programs. However, despite carefully planned environments and vigilant supervision, injuries can still occur. Young children are naturally active and curious. Their motor skills are developing, and they are also in the early stages of learning about risks and consequences. These factors put young children at high risk for injuries.
Characteristics of group care settings, such as the presence of multiple children, furniture, toys, and the physical environment (radiators, doors, fences, gates, etc.) also can contribute to injuries in childcare programs.
Every childcare program should have a comprehensive safety plan. Staff should be trained to prevent and manage injuries, as well as how to document and record incidents when they occur.
While most injuries that occur in childcare are relatively minor, like bruises or scrapes, any injury or incident should be documented.
What Should Be Included in Injury Records?
Caring for Our Children national standards recommends including the following information on the injury reporting form:
- Name, gender, and age of the injured child
- Date and time of injury
- Location where the injury took place
- Description of how the injury occurred
- Names and contact information of witnesses to the accident, as well as what the child reported
- Body parts involved
- Description of any consumer product involved
- Name and location of staff responsible for supervising the child at the time of the incident
- Actions taken on behalf of the injured following the injury
- Recommendations for preventative strategies for the future
- Name of person completing the report, and name and address of the program
Every childcare program should have a written policy and procedure for documenting and reporting incidents. For example, you might require several signed copies of the completed injury report form. Copies should be given to the child’s parent or legal guardian and also maintained in the child’s folder.
Depending on your state’s specific childcare injury regulations and the specifics of the incident, you may file additional copies with your state licensing agency or health consultant. A copy may also be maintained in a chronologically filed injury/incident log. Periodic review of the injury/incident log may reveal patterns of injury.
Circumstances Requiring an Injury Report
Caring for Our Children recommends that an injury report be completed whenever an injury occurs in the childcare facility that requires first aid or medical attention for a child or adult. Even minor injuries that require simple first aid, such as a band-aid or a cold compress, should be reported.
If you are not sure if a form should be completed, err on the side of caution and complete the form. It is important to document while the incident is still fresh in your mind and you can recall details.
An injury to a child in your care is stressful, and recounting the incident on a form may be intimidating. You may be concerned that reporting and documenting injuries can cause problems for you professionally.
However, thorough documentation and reporting indicates competence and responsibility and is to your advantage. Injuries can occur, even with a safely designed environment and appropriate supervision.
Patterns of Injury
Injury patterns can warn of hazards in the childcare environment. For example, several children tripping over a rug indicates that it is placed inappropriately or it is not a safe surface. An injury file will help you assess hazards in your childcare program so you can correct them before additional injuries occur.
Caring for Our Children recognizes the importance of reporting injuries to state licensing agencies and health consultants. When data are compiled from many childcare programs, patterns begin to emerge.
For example, a specific type of fence or gate may be linked to a certain type of injury (e.g., accordian-style gates caused strangulation injury). In such cases, childcare programs can be alerted to avoid further injuries. If several children have been pinched by a specific toy, the state agency may report the pattern to the manufacturer or the Consumer Product Safety Commission, and the toy may be recalled.
Another pattern that may emerge is that a single child may have repeated injuries that other children do not sustain in similar play activities. This may be an indicator that a child is struggling with a developmental or physical issue, such as perception, balance, or vision. Such situations may warrant additional observation or referral to the child’s parents and appropriate health professional.
Injuries to Staff
Staff and adult injuries also should be reported. Staff should work in a safe environment, and reporting injuries helps program directors address problems efficiently.
The injury report form used for children also can be used to document staff injuries, with copies distributed to appropriate individuals.
Informing Families about Injuries
When families enroll children in your childcare program, review with them the policies and procedures related to reporting injuries. Give them a copy of the injury reporting form and emphasize that you will document any injury, regardless of how minor.
Explain that this policy helps improve your childcare program and creates awareness of hazardous situations. Parents will appreciate that you are vigilant and conscientious.
Marna Holland, PhD
Parent Educator, Asheville City Preschools, Asheville, NC
Caring for Our Children: National Health and Safety Performance Standards, National Resource Center for Health and Safety in Child Care and Early Education, nrc.uchsc.edu/CFOC
Safety in Early Childhood Environments, www.education.com/reference/article/safety-early-childhood-environments
Injury Reporting, Healthy Childcare®, www.healthychild.net/SafetyFirst.php?article_id=172
Injury Topics: Child Care Safety, Children’s Safety Network, www.childrenssafetynetwork.org/default.asp