Does teaching scald burn prevention to families of young children make a difference? A pilot study

doi:10.1053/jpdn.2001.25535

Journal of Pediatric Nursing

Volume 16, Issue 4, August 2001, Pages 256-262

https://doi.org/10.1053/jpdn.2001.25535 Get rights and content

Abstract

This article reports a pilot project designed to ascertain what scald burn prevention practices parents of young children used and whether teaching would lead to implementation of burn-related home-safety practices. The sample (n = 49) was followed up longitudinally, and participants completed a survey during two home interviews conducted at 4-week intervals. There was a statistically significant change in the number of scald burn prevention measures (p < .001) implemented by parents after public health nurses provided teaching. Changes in parental behavior were correlated with ethnicity (p < .05). The results have implications for teaching families effective scald burn prevention strategies. Copyright © 2001 by W.B. Saunders Company

Section snippets

Scald burn incidence and risk in young children

Scald burns from hot liquids are the most frequent cause of nonfatal burn injuries, and 75% of victims are younger than age 3 (Ray, 1995). Hot tap water and kitchen spills cause most scald burns (Banco, Lapidus, Zavoski, & Braddock, 1994). Kitchen scald burns from hot liquids and beverages are the most common burns suffered by young children and represent 60% of unintentional scald burns (Huyer & Corkum, 1997). The remainder of scald burns take place in the bathroom and are caused by hot water.

Purpose

The purpose of the study was to determine whether providing scald burn prevention interventions to parents of children younger than age 5 had an effect on scald burn-related home-safety practices. Research questions included (1) does verbal teaching regarding scald burn prevention have an effect on home-safety practices in this area? (2) are parents of children with certain demographic or risk factors more likely to implement burn-related home-safety practices? (3) before interventions, what

Theoretical framework

The theoretical framework used to guide this current study was based on the Self-Care Deficit Theory of Nursing that was developed by Dorothy Orem (Marriner-Tomey, 1994). Orem's theory comprises the following three related theories: self-care, self-care deficit (outlines why people can be assisted through nursing), and nursing systems (details the relationships that need to be established and developed for nursing to be produced). According to Orem, self-care is a general requirement for

Design

For this study a quasi-experimental design was used. The study was based on the premise that a public health nurse who provided home visits to families with young children could provide teaching about scald burn prevention that would lead to the adoption of pertinent safety measures by parents in the home setting.

Sample

The parents who completed the survey were nonrandomly selected and had at least one child younger than age 5 at the time of survey completion. The families were all enrolled in a

Results

Analysis of the difference in mean scores of correct burn prevention practices from the first to the second assessment was performed using a paired comparison t test. This analysis indicated a statistically significant change in the numbers of scald burn-prevention measures (p < .001) implemented by parents after the public health nurses provided teaching. The mean number of items needing change at baseline was 8.6 (range, 1 to 13; SD = 3.14). After the intervention, parents implemented a mean

Discussion and implications for practice

Unintentional scald burn injuries in young children can have devastating effects on the lives and health of many families. This public health problem has enormous costs and in many cases is preventable. This is the first study to show a significant effect of teaching on a variety of specific scald burn prevention practices in a cohort of parents of young children in the home setting. The results of this pilot project support previous reports that home visiting fosters healthy behaviors. Changes

Acknowledgements

The authors wish to thank the nurses and families who participated in the project.

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Identification of populations in our catchment area at high risk for burns is essential for focused burn prevention programs in our community areas. The literature supports that burn prevention programs reduce the incidence of burns in a community [28,29]. Cagle et al. demonstrated that providing parents with burn safety workshops and environmental change suggestions does decrease the incidence of burns in a target population [28].
Burn injuries account for significant morbidity in the pediatric population. There is no structured data to describe the pediatric burns epidemiological profile in Eastern Ontario, Canada.
The aim was to establish a pediatric burn database in order to assess our current standard of practice, the burn epidemiology, and develop a framework for focused burn prevention programs in our catchment area.
A pediatric burn database was built in REDCap at the Children’s Hospital of Eastern Ontario (CHEO) retrospectively for 2010–2015 period. Data points included demographic data, details about the injury and description of the burn wounds. Rural and urban living was classified as per the Canadian Postal Service.
A total of 695 patients were seen as outpatients. Burns included 51.6% scald, 30.6% contact, and 9.6% flame injuries. Mean age was 4.25 years, and mean burn extent was 4.4% total body surface area (TBSA). Patients from rural areas had sustained burns wounds due to flame and contact with hot surfaces (p < 0.05), whereas children from urban areas had hot liquids as main etiology (p < 0.05).
The pediatric burn injuries in our catchment area are mainly scald burns, and relatively small. The newly created outpatients burn database will aim to tailor the burn prevention programs. Primary burn prevention through education is essential in future burn reduction strategies.
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Our study's finding would suggest that this does not prevent significant kettle scalds from pulling on the cord and legislation needs to address this urgently. In general, scald prevention campaigns have been ineffective [36–38] although the majority have not highlighted the kettle cord as an area for prevention [39,40]. Sheller et al. showed a theoretical reduction in scald injuries from kettles in Norway after a successful preventative campaign involving a national television and radio broadcast and numerous health publications highlighting the need for the cord to be out of children reach when the kettle was in use.
Kettle scalds are a major cause of paediatric burn injury. Whilst preventative measures have been advocated for years, the incidence of this type of injury is increasing. Information is lacking regarding severity and mechanism of injury.
We prospectively analysed all paediatric scald injuries that warranted referral to a tertiary burn centre to quantify severity, outcome, look into how these burns occurred with a view to providing information for preventative strategies and audited the safety features of 19 top selling kettles.
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The amount of time required to adequately convey a burn-injury prevention curriculum is age dependent. Shorter instruction periods have been tried in elementary schools, often by incorporating games or by shifting instruction to outside the classroom through take-home exercises [31,74,75]. Making the sessions as part of the extra curricular activities on a regular basis is of utmost importance [4].
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Like other injury mechanisms, the prevention of burns requires adequate knowledge of the epidemiological characteristics and associated risk factors, it is hence important to define clearly, the social, cultural and economic factors, which contribute to burn causation. While much has been accomplished in the areas of primary and secondary prevention of fires and burns in many developed or high-income countries (HICs) such as the United States due to sustained research on the epidemiology and risk factors, the same cannot be said for many LMICs. Many health authorities, agencies, corporations and even medical personnel in LMICs consider injury prevention to have a much lower priority than disease prevention for understandable reasons. Consequently, burns prevention programmes fail to receive the government funding that they deserve.
Prevention programmes need to be executed with patience, persistence, and precision, targeting high-risk groups. Depending on the population of the country, burns prevention could be a national programme. This can ensure sufficient funds are available and lead to proper coordination of district, regional, and tertiary care centres. It could also provide for compulsory reporting of all burn admissions to a central registry, and these data could be used to evaluate strategies and prevention programmes that should be directed at behavioural and environmental changes which can be easily adopted into lifestyle. Particularly in LMICs, the emphasis in burn prevention should be by advocating change from harmful cultural practices. This needs to be done with care and sensitivity.
The present review is a summary of what has already been accomplished in terms of burn prevention highlighting some of the successes but above all the numerous pitfalls and failures. Recognizing these failures is the first step towards development of more effective burn prevention strategies particularly in LMICs in which burn injury remains endemic and associated with a high mortality rate. Burn prevention is not easy, but easy or not, we have no options; burns must be prevented.
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Studies have demonstrated that appropriate burn-prevention education can reduce the risk of childhood burn injuries. For example, Corrarino and colleagues have shown that while some minority populations are less likely to practice safe burn-avoidance behaviors at home, after counseling and burn-prevention education, they are significantly more likely to make behavioral changes compared to their Caucasian counterparts [13]. Children from high-risk groups can be identified by their elementary school teachers and targeted for burn-prevention education.
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^*: This project was supported in part by a grant from the New York State Department of Health Injury Control Unit.

^☆☆: Address reprint requests to Jane E. Corrarino, Suffolk County Department of Health, 225 Rabro Dr., Hauppauge, NY 11788. E-mail: [email protected]

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ArticlesDoes teaching scald burn prevention to families of young children make a difference? A pilot study*,☆☆

Abstract

Section snippets

Scald burn incidence and risk in young children

Purpose

Theoretical framework

Design

Sample

Results

Discussion and implications for practice

Acknowledgements

Patient Education and Counseling

Canadian Journal of Public Health

American Journal of Preventive Medicine

Primary Care

Burns

Burn injuries among children in an urban emergency department

Pediatric Emergency Care

Pediatric injury prevention counseling priorities

Pediatrics

Childhood injuries in the United States

American Journal of Diseases of Children

Nursing forum: Burns

Journal of Burn Care & Rehabilitation

Childhood injuries in the United States: Mortality, morbidity, and cost

American Journal of Diseases of Children

Unintentional infant injuries: Sociodemographic and psychosocial factors

Public Health Nursing

Reducing the incidence of tap-water scalds: Strategies for physicians

Canadian Medical Association Journal

A randomized single-blind evaluation of a discharge teaching book for pediatric patients with burns

Journal of Burn Care & Rehabilitation

Childhood residential injuries. MCN

The American Journal of Maternal Child Nursing

Articles
Does teaching scald burn prevention to families of young children make a difference? A pilot study*,☆☆