Child passenger safety education in the emergency department: teen driving, car seats, booster seats, and more

Smola, Cassi; Sorrentino, Annalise; Shah, Nipam; Nichols, Michele; Monroe, Kathy · 2020 · DOAJ

DOI: 10.1186/s40621-020-00250-5

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Summary

This study addresses the critical need for child passenger safety (CPS) education in emergency departments (EDs), where motor vehicle crashes are a leading cause of death for children under 19. Despite recommendations from organizations like the National Highway Traffic Safety Administration for hospital-based CPS programs, prior research indicates that injury prevention counseling by ED staff is inconsistent and often hindered by a lack of training and confidence. The authors aimed to determine the baseline knowledge and counseling behaviors of pediatric ED nurses regarding CPS and to evaluate the impact of a targeted educational intervention on these metrics. The researchers conducted a pre/post intervention study at the Children’s of Alabama pediatric ED in February 2018. The study involved 83 ED nurses who completed a pre-intervention survey, with 64 nurses subsequently receiving the educational intervention and completing a post-intervention survey. The intervention consisted of a one-hour lecture based on American Academy of Pediatrics (AAP) guidelines and Alabama state laws, covering topics such as car seat and booster seat age requirements, front-seat riding rules, and teen driving risks. Data were collected via surveys assessing CPS knowledge and self-reported counseling frequency. Statistical analysis included McNemar’s test for matched pairs and Chi-square tests for categorical variables. Results indicated that while baseline knowledge regarding motor vehicle crashes as the leading cause of death was high (>98%), knowledge of specific CPS regulations was lower. Following the intervention, five of seven knowledge questions showed statistically significant improvement, including understanding of front-seat riding ages, graduated driver licensing laws, and booster seat requirements. Regarding counseling behaviors, baseline rates were low; for instance, 88% of nurses reported never or only occasionally counseling about teen driving. Post-intervention, intent to counsel increased across all categories, with the increase in intent to counsel regarding teen driving reaching statistical significance (p = 0.01). No significant differences in baseline knowledge were found between nurses with less than one year of experience and those with two or more years. The study concludes that a brief educational intervention can significantly improve pediatric ED nurses’ knowledge of CPS guidelines and their intention to counsel families. The findings suggest that targeted education can address barriers such as lack of confidence and training, potentially leading to better adherence to safety recommendations. The authors emphasize the importance of continuing education to sustain these improvements and recommend future studies to assess long-term retention and actual counseling behaviors rather than just intent. This work supports the integration of structured CPS education into ED nursing protocols to enhance patient safety outcomes.

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• child passenger safety