Emergency department may be an ideal setting for teaching home injury prevention


Caregivers may be willing to accept home safety information after a child is injured

Hospital emergency departments may provide an effective setting for parents to learn injury prevention. Researchers from The Children's Hospital of Philadelphia studied parents of injured preschoolers in the emergency department and found that the emergency department (ED) may be an effective environment to disseminate home injury prevention information. This study was published in the June issue of the journal Pediatrics.

"This study's novelty lies in its setting, the emergency department, an environment not traditionally used for home injury prevention education," said Jill C. Posner, M.D., M.S.C.E., an emergency medicine physician at Children's Hospital and primary investigator of the study. "This approach may contribute to the success of the intervention during a 'teachable moment' when caregivers may be more receptive to prevention education."

Researchers conducted a randomized, clinical trial of 96 consecutive caregivers of children who were younger than 5 years old and visited the emergency department at The Children's Hospital of Philadelphia for evaluation of an unintentional injury that occurred in the child's home.

After completing a safety questionnaire during a face-to-face interview, caregivers were randomly assigned to receive either comprehensive home safety education and free safety devices or focused, injury-specific emergency department discharge instructions. The home safety kit included cabinet and drawer latches, electrical outlets covers, tub spout covers, non-slip bath decals, bath water thermometer, small parts tester (choking tube), poison control telephone number stickers, and literature related to fire and window safety.

Participants were contacted approximately two months after their initial ED visit for repeat administration of the safety questionnaire. Parents who received the safety education and safety devices improved significantly in poison, cut/piercing, and burn prevention; they also demonstrated significantly greater use of childproofing devices.

"We believe the ED may represent an under-recognized site for the dissemination of targeted injury prevention information," said Dr. Posner. "Although the ED cannot and should not replace the role of the primary care physician's office in providing anticipatory guidance, this study shows that the ED visit can be used effectively to disseminate home injury prevention information."

The primary care visit, said Dr. Posner, is a natural setting for home injury prevention information dissemination. However, research shows that there are numerous constraints on primary care providers' time during a well-care visit due to the wealth of information that needs to be covered. Also, during a well-care visit parents may not think about potential dangers in their home that might harm their child. Therefore, she advises, the ED setting after an injury may be a "teachable moment" for parents due to the immediacy of a child's injury.

Millions of children throughout the U.S. are injured in their homes each year. Injuries from falls, poisonings, fires, burns, lacerations, and suffocations are the leading causes of injury and death during childhood.

Dr. Posner's coauthors were Linda A. Hawkins, M.S.Ed., Felipe Garcia-Espana, Ph.D., and Dennis R. Durbin, M.D., M.S.C.E., all of The Children's Hospital of Philadelphia.

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
    Published on PsychCentral.com. All rights reserved.