Written by Clare Haynes, Paediatric Injury Surveillance Nurse
As of 2023, the Royal Darwin Hospital (RDH) Trauma Service Research and Registry team, funded by the NCCTRC, has a revitalised focus on the Paediatric Injury Surveillance database, with the primary objective to improve children’s safety and well-being in the Northern Territory (NT).
Injury is the leading cause of death in children aged 0 to 14 years of age in Australia [1] and childhood injuries can have a significant impact on the lives of children and their families. The NT is a unique jurisdiction with the highest proportion of Indigenous Australians (approximately a third of the population), and a far greater proportion of the NT’s Indigenous population live in remote and very remote areas compared with other jurisdictions [2]. Data is increasingly valuable for developing long term sustainable outcomes for all members of society and ensuring a better understanding when underpinning public health initiatives.
The World Health Organization defines public health surveillance as “the continuous and systematic collection, orderly consolidation and evaluation of pertinent data with prompt dissemination of results to those who need to know, particularly those who are in a position to take action”.
Current available data demonstrates that children in outer regional, remote and very remote areas were three times more likely to die from injuries when compared with children in major cities [2]. National data demonstrates that in the NT, Indigenous children are over-represented when it comes to child safety and injury mortality. The purpose of the Paediatric Injury Surveillance database is to add to existing knowledge and analyse trends of childhood injury in the NT and ultimately contribute to reducing the burden of childhood injuries. Accepting the distinctive features of the NT when it comes to paediatric injuries, there is an increased value in a robust surveillance system to lead to effective prevention strategies.
The Paediatric Injury Surveillance project was first established in 2015 by the NT Centre for Disease Control (CDC) to address a recognised gap in available data on childhood injuries. The NCCTRC then assumed leadership of the project in 2018. A database was created which is managed within the RDH Trauma Service to record relevant information regarding the injuries that present to Emergency Departments (ED) in the Top End region of the NT.
We are currently collecting data on all injury presentations to the Royal Darwin and Palmerston Hospital ED’s for children aged 0 to 15 years of age inclusive. The data collected includes the mechanism of injury, where the injury occurred, any object or substance involved, the activity when injured (including specific sports), intent, the nature and bodily location of the injury, as well as if any safety countermeasures were used. This allows us to collate injury data to recognise trends and report on the epidemiology of childhood injury specific to the NT, focussing on patterns of injury distribution in children and young people and why this occurs.
Collection of data was affected during the COVID-19 pandemic. The re-establishment of the Paediatric Injury Surveillance database provides the RDH Trauma Research and Registry team an opportunity to evaluate and update the system, and ensure processes align with other jurisdictions and NT Health requirements. It is vital that the results of this data collection are shared with key stakeholders, especially those involved in childhood safety such as Kid Safe NT, in order to inform policy and prevention measures at a local level. There needs to be a strong commitment to the sustainability of this project with emphasis on a foundation of robust data collection and collation.
Each State and Territory conducts injury surveillance in a diverse range of methods. The Trauma Research and Registry team are linking in with cross-jurisdictional discussions aimed towards aligning injury surveillance data nationally. We are working in collaboration with NT Health and the NT CDC to align processes and are fortunate to be closely linked to the Trauma Service as part of the team that provide care for injured patients on the ground.
A National Injury Prevention Strategy is currently being developed with a renewed focus on prevention of injury, [6] and has identified that special consideration needs to be given to prevention of injury for children and Aboriginal and Torres Strait Islander people. A large burden of disease study looking at 20 years of mortality data in the NT found that intentional and unintentional injury disproportionally affected young people aged 5–29 in the Aboriginal population [8].
As I develop further in this role as a Paediatric Injury Surveillance Nurse, I am excited to see a strong focus on injury prevention both in the NT and nationally. I am passionate about the outcomes we can achieve through development in this area and I look forward to further collaboration with key stakeholders as we work towards further supporting injury prevention for the NT’s young people, as our data will be most relevant for change at a local level.
As the WHO states, effective public health prevention programs rely on good quality surveillance systems [3]. Therefore, a strong commitment to ongoing robust paediatric injury surveillance at the RDH Trauma Service is required if we are to make a difference in reducing the impact of the morbidity and mortality of injury for children and their families, who are the future of the NT.
Additional reading and references:
- Australia's children, Injuries - Australian Institute of Health and Welfare (aihw.gov.au)
- Population - Northern Territory Economy
- WHO EMRO | Public health surveillance | Health topics
- Victorian Injury Surveillance Unit (VISU) - Accident Research Centre (monash.edu)
- QISU | Queensland Injury Surveillance Unit (health.qld.gov.au)
- National Injury Prevention Strategy - Australian Government Department of Health - Citizen Space
- National Injury Prevention Strategy Literature review_FINAL.pdf (georgeinstitute.org)
- Mortality burden of disease and injury in the Northern Territory 1999–2018
Clare Haynes
Paediatric Injury Surveillance Nurse
Clare Haynes is the Paediatric Injury Surveillance Nurse with the NCCTRC’s Trauma Service located at the Royal Darwin Hospital. Clare comes from a background in Emergency Nursing as well as Paediatric and Child Health Nursing. She explains her passion for nursing is derived from working with children and their families to help facilitate the best possible start at life, and ensuring clients are respected in the health system. Clare has been based in the Northern Territory for 9 years and believes the variety of work that the NT offers provides constant opportunities for innovation and fostering long-term sustainable projects in healthcare.