"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.
Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital of Philadelphia is ranked in 2003 as the best pediatric hospital in the nation by U.S.News & World Report and Child magazines. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding among children's hospitals. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents from before birth through age 19. Children's Hospital operates the largest pediatric healthcare system in the U.S. with more than 40 locations in Pennsylvania, New Jersey and Delaware.
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PEDIATRICS