Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
Arch Dis Child. 2010 Apr;95(4):291-5. doi: 10.1136/adc.2009.167619. Epub 2009 Nov 29.
New national procedures for responding to the unexpected death of a child in England require a joint agency approach to investigate each death and support the bereaved family. As part of a wider population-based study of sudden unexpected deaths in infancy (SUDI) we evaluated the implementation of this approach.
A process evaluation was carried out using a population-based study of all unexpected deaths from birth to 2 years in the South West of England between January 2003 and December 2006. Local police and health professionals followed a standardised approach to the investigation of each death, supported by the research team set up to facilitate this joint approach as well as collect data for a wider research project.
We were notified of 155/157 SUDI, with a median time to notification of 2 h. Initial multi-agency discussions took place in 93.5% of cases. A joint home visit by police officers with health professionals was carried out in 117 cases, 75% within 24 h of the death. Time to notification and interview reduced during the 4 years of the study. Autopsies were conducted on all cases, the median time to autopsy being 3 days. At the conclusion of the investigation, a local multi-agency case discussion was held in 88% of cases. The median time for the whole process (including family support) was 5 months.
This study has demonstrated that with appropriate protocols and support, the joint agency approach to the investigation of unexpected infant deaths can be successfully implemented.
英国针对儿童意外死亡的新国家程序要求联合机构采取联合方法调查每起死亡事件并为死者家属提供支持。作为婴儿突发意外死亡（SUDI）更广泛的基于人群研究的一部分，我们评估了这种方法的实施情况。
我们使用 2003 年 1 月至 2006 年 12 月期间英格兰西南部出生至 2 岁之间所有意外死亡的基于人群的研究，进行了一项过程评估。当地警察和卫生专业人员按照标准方法调查每起死亡事件，由专门成立的研究小组提供支持，以促进这种联合方法，并为更广泛的研究项目收集数据。
我们接到了 155/157 例 SUDI 的通知，通知中位数时间为 2 小时。93.5%的病例进行了初步多机构讨论。在 117 例病例中，警察与卫生专业人员进行了联合家访，75%的病例在死亡后 24 小时内进行。在研究的 4 年中，通知和访谈的时间减少了。所有病例都进行了尸检，尸检中位数时间为 3 天。在调查结束时，88%的病例举行了当地多机构案例讨论。整个过程（包括家庭支持）的中位数时间为 5 个月。
这项研究表明，通过适当的协议和支持，可以成功实施联合机构方法调查意外婴儿死亡事件。
