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Nursing Students Apply Evidence-Based Research Principles in Primary Burn Prevention Projects
Journal of Pediatric Nursing (2010) 25, 477–481
Nursing Students Apply Evidence-Based Research Principles in Primary Burn Prevention Projects Carlee Lehna PhD, ARNP ⁎, Phil Love MS, BS, Stephanie Holt BS, Brittany Stokley BS, Anna Vissman BA, Teriea Kupiec BA, Sherri Starks BA, Kasey Chesser, Heather Karem BA, Ashley Probus BS, Kathryn Dunlap BA University of Louisville School of Nursing, Louisville, KY
Key words: Registered nursing students; Burn prevention projects; Evidence based research
The purpose of this project was for registered nursing students in a baccalaureate nursing program to look at different prevention strategies that could be utilized in the community to impact change in a family's burn prevention knowledge. The prevention strategies and their corresponding interventions were written in a narrative form, and then a poster was created to serve as a supplemental visual aid for the information. Firefighters from a local fire department evaluated posters and their abstracts based on criteria developed by the students. Five posters were revised and submitted to a national burn prevention contest. Students gained valuable experience in developing and revising evidence-based research (EBR) projects to promote community education in primary burn prevention with firefighter collaboration. © 2010 Elsevier Inc. All rights reserved.
IN 2007, 127,016 people suffered from having a fire impact their life (United States Fire Administration [USFA], 2008). Of those, 3,430 lost their lives (USFA). According to the National Fire Protection Association (NFPA), there were 1,557,500 fires reported in 2007, of which 530,500 were structure fires, 258,000 were vehicle fires, and 769,000 were classified as outside or other (NFPA, 2008a). For the 20,000 children less than 5 years of age burned in 2008, burns from scalds were the greatest source of injury, followed by those from flame sources (American Burn Association, 2009). Children between 5 and 19 years of age were most frequently burned by flames and then by scalding themselves. Fires and the health care needs associated with them have become an increasing issue in the United States. Many of the ⁎ Corresponding author: Carlee Lehna, PhD, ARNP. E-mail addresses: [email protected] (C. Lehna), [email protected] (P. Love), [email protected] (S. Holt), [email protected] (B. Stokley), [email protected] (A. Vissman), [email protected] (T. Kupiec), [email protected] (S. Starks), [email protected] (K. Chesser), [email protected] (H. Karem), [email protected] (A. Probus), [email protected] (K. Dunlap) 0882-5963/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.pedn.2009.11.003
fires and their associated injuries could be prevented with an increased awareness and knowledge concerning fires and burn prevention techniques. This includes responding promptly and quickly to fires by alerting the fire department, taking it upon oneself to learn ways in which fires can be prevented and implement them in one's own household, and sharing the information with others. The nurse is focused on the care of burn victims following an incident. It is important to change the nurse's focus to include primary prevention to help prevent the devastation that a fire injury causes a patient (Herndon, 2007; Lehna, 2007). Burn prevention education should be a part of the education process in the community, specifically in the pediatric population and their families (Lehna). Burn prevention knowledge assessment is an important consideration when evaluating children and their parents to ascertain the appropriate educational level and the teaching that is needed (Lehna). Within the community, there are thousands who have suffered the pain, anguish, and loss that surrounds a burn injury (Lehna). These consequences are as equally devastating to the family, and this need for education concerning prevention is necessary across the spectrum to impact change.
478
Purpose The purpose of this project was to look at different burn prevention strategies that could be utilized in the community to impact change in family burn prevention knowledge. One specific aim was for registered nursing students to support their burn prevention topic choice based on the existing burn prevention evidence. An additional aim was for nursing students to learn how to assess learning needs and develop and evaluate a burn prevention project with their patients. Furthermore, it was hoped that nursing students would understand the importance of collaborating with other agencies within their community to reach their goal. Ultimately, it was hoped that nursing students would provide the community with educational tools that could decrease the number of accidental fires and the injuries associated with them.
Project During the fall of 2008, 10 registered nursing students, in a baccalaureate nursing program during their pediatric clinical experience, developed burn prevention posters with accompanying one-page abstracts. A team of two students addressed one topic. The one-page abstract accompanying the posters described the target audience, why the topic was chosen, and how the poster was going to be used in prevention activities. Students, then, developed an evalua-
tion form that outside burn prevention experts could use to rate their abstracts and posters. The poster evaluation was based on the following areas: the creativity of the topic, creativity of the poster, content, clarity, and application. The areas for evaluation were further
C. Lehna et al. clarified as topic creativity met an identified community need; poster creativity conveyed the message through use of design, graphics, and text; content included identification of the target audience, provision of relevant information, and whether rationale for topic choice was supported with evidence; clarity evaluated poster readability; and application judged whether the poster was realistic and feasible. The students' clinical instructor asked a local platoon of firefighters from the Louisville Metro Fire Department to be evaluators. The areas of burn prevention chosen by the students based on their literature search were camp fire safety, candle safety, Christmas tree safety, electrical safety, and scald prevention.
Camp Fire Safety The topic of campfire safety was chosen to address the number of burns that are caused from camp fires and the amount of land that is destroyed due to improper camp fire activities (American Academy of Pediatricians, 2008; Life Learning Systems, 2008). In addition, this topic was chosen because many individuals are unaware of the proper techniques for conducting a safe bonfire and the negative impact that it can have if a safe environment is not maintained throughout the bonfire experience (Life Learning Systems). The NFPA reported in 2007 that 769,000 fires were from the outdoors resulting in 45 deaths, 650 injuries, and $790 million in loss (NFPA, 2008a). The NFPA also reported that 37% of outdoor fires were caused by an open flame such as a campfire.
Candle Safety The topic of candle safety was chosen due to its importance, the lead containing properties of candles, and the other parts of a candle that can impose harm to children
Evidence Based Research
479
(National Candle Association, 2008). According to the NFPA (2008b), “Candle fires resulted in an estimated 150 civilian deaths, 1,270 civilian injuries and an estimated direct property loss of $539 million.” Thus, the need for educating is importance when considering candle safety.
with household electrical cords and extension cords. Wall outlets are associated with an additional 14% of these injuries (NSKC).” It is anticipated that the education presented will teach children to avoid existing dangers and to notify a responsible adult to rectify the hazard.
Christmas Tree Safety
Therefore, by focusing on this age group and their caregivers, it is hoped that household electrical hazards will be identified and corrected before these problems result in fire and injury.
The topic of Christmas tree safety was chosen due to during the holiday season, many fires are the result of Christmas trees. According to the NFPA (2008), there is an average of 600 fires per year in the United States caused by the ignition of Christmas trees. On average, such fires result in 112 injuries and $21 million in direct property damage per year. Almost half of Christmas tree fires are caused by electrical failure or malfunction. By keeping your Christmas tree watered and properly maintained, the extent of a fire is drastically reduced. Several research videos are available to compare the spread of fire with a dry Christmas tree compared to a watered Christmas tree. Christmas tree fires can develop and spread very quickly (NFPA, 2008).
Electrical Safety The prevention strategy for electrical safety centered on a statistic from the National SAFE KIDS Campaign (NSKC, 2004), which stated that “nearly two thirds of electrical burn injuries among children ages 12 and under are associated
Scald Safety This topic of scald safety is important because it is the most common injury for young children. According to NFPA, fire and burns are the leading cause of unintentional injury-related death for children ages 1 to 4 years (Injury Prevention Web, 2008). In addition, according to the U.S. Consumer Product Safety Commission, approximately 3,800 injuries and 34 deaths occur in the home each year due to scalding from excessively hot tap water (Home Safety Council, 2008). Hot water, including tap water in bathtubs and showers, is the leading cause of both scalds and hospital admissions for burns (NFPA, 2008a). Because infants, young children, and older people may not be able to respond quickly to a situation involving contact with hot water, a constant safe water temperature is essential for preventing scalds from tap water (Injury Prevention Web, 2008).
480
C. Lehna et al.
Evidence Based Research The firefighters judged the Christmas tree safety poster best, followed by the camp fire safety poster, and in third place was the poster on electrical safety. Students, using these comments revised their posters and submitted them to a national fire prevention poster contest. Time did not allow for the students to implement their posters within the community and evaluate this phase of the project.
Discussion The inclusion of the burn prevention project provided an EBR component to the student's pediatric clinical experience. The EBR component supplied the students with experience in research techniques, working in groups to create their projects, analyzing data, investigating community resources, and writing findings. The clinical instructor and the students agreed that this project would be beneficial to the community by increasing awareness of the devastation that fires can bring and by providing interventions for preventing this devastation from occurring. The drawback was the timing of this project. According to the students and the supervising faculty, the students were overwhelmed by the requirements that had previously been set forth in their nursing classes and other clinical experiences. On the positive side, this project served to foster building a relationship between the students, the supervising faculty, and the local fire department. By speaking with each other, the students and firefighters strengthened their understanding of their respective roles in the prevention and treatment of fires and their resulting burns to children and their families. Plans are to continue using this type of project for future clinical groups. Project changes would be to describe requirements at the beginning of the clinical experience, to include implementation of projects in various settings, and to complete participant evaluation. The EBR helped the registered nursing students gain valuable mentored experience in researching, developing, evaluating, and disseminating the information from their
481 primary burn prevention projects. This experience was not without its negative perspectives and involved extra work on the part of all participants. Clear and detailed EBR requirement description, with requirements for implementation and evaluation, would facilitate future student learning of EBR principles. EBR evaluation data would provide valuable feedback in aiding student understanding of EBR within a specific setting and in developing and implementing burn prevention strategies to reduce devastating burn injuries in children. Implementation sites might include schools, children's toy and clothing stores, camp grounds, or building supply stores.
References American Academy of Pediatricians (AAP). (2008). Follow these hot tips for campfire safety. AAP News, 29, 29. American Burn Association (ABA). (2009). National burn repository. Chicago, IL: Author. Herndon, D. N. (2007). Total burn care. Philadelphia: W. B. Saunders. Home Safety Council. (2008). Home safety tips: Water safety tips. Available at: http://www.homesafetycouncil.org/safety_guide/sg_ water_w004.aspx/ Internet; accessed 28 Sept. 2008. Injury Prevention Web. (2008). Injury prevention policy: Tap water scalds. Available at: http://www.safetypolicy.org/pm/scald.htm Internet; accessed 28 Sept. 2008. Lehna, C. (2007). Pediatric nurses' knowledge about burn prevention. Journal of Burn Care & Research, 28, S114. Life Learning Systems. (2008). Campfire safety. Available at: http://www. smokeybear.com/campfire-safety.as Internet; accessed 30 Sept. 2008. National Candle Association. (2008). Available at: http://www.candles.org/ safety_candles.htm. Internet; accessed 29 Sept. 2008. National Fire Protection Agency (NFPA). (2008). Research and reports: Christmas tree fires. Available at: www.nfpa.org Internet; accessed 27 Sept. 2008. National Fire Protection Association (NFPA). (2008a). Fire statistics. Available at: http://www.nfpa.org Internet; accessed 24 Nov. 2008. National Fire Protection Association (NFPA). (2008b). Candle safety. Available at:. http://www.nfpa.org Internet; accessed 29 Sept. 2008. National SAFE KIDS Campaign (NSKC). (2004). Burn Injury Fact Sheet 2004. Available at: http://www.usa.safekids.org Internet; accessed 27 Sept. 2008. United States Fire Administration (USFA). (2008). Statistics. Available at: http://www.usfa.dhs.gov/statistics/quickstats/index.shtm Internet; accessed 24 Nov. 2008.
Nursing Students Apply Evidence-Based Research Principles in Primary Burn Prevention Projects Carlee Lehna PhD, ARNP ⁎, Phil Love MS, BS, Stephanie Holt BS, Brittany Stokley BS, Anna Vissman BA, Teriea Kupiec BA, Sherri Starks BA, Kasey Chesser, Heather Karem BA, Ashley Probus BS, Kathryn Dunlap BA University of Louisville School of Nursing, Louisville, KY
Key words: Registered nursing students; Burn prevention projects; Evidence based research
The purpose of this project was for registered nursing students in a baccalaureate nursing program to look at different prevention strategies that could be utilized in the community to impact change in a family's burn prevention knowledge. The prevention strategies and their corresponding interventions were written in a narrative form, and then a poster was created to serve as a supplemental visual aid for the information. Firefighters from a local fire department evaluated posters and their abstracts based on criteria developed by the students. Five posters were revised and submitted to a national burn prevention contest. Students gained valuable experience in developing and revising evidence-based research (EBR) projects to promote community education in primary burn prevention with firefighter collaboration. © 2010 Elsevier Inc. All rights reserved.
IN 2007, 127,016 people suffered from having a fire impact their life (United States Fire Administration [USFA], 2008). Of those, 3,430 lost their lives (USFA). According to the National Fire Protection Association (NFPA), there were 1,557,500 fires reported in 2007, of which 530,500 were structure fires, 258,000 were vehicle fires, and 769,000 were classified as outside or other (NFPA, 2008a). For the 20,000 children less than 5 years of age burned in 2008, burns from scalds were the greatest source of injury, followed by those from flame sources (American Burn Association, 2009). Children between 5 and 19 years of age were most frequently burned by flames and then by scalding themselves. Fires and the health care needs associated with them have become an increasing issue in the United States. Many of the ⁎ Corresponding author: Carlee Lehna, PhD, ARNP. E-mail addresses: [email protected] (C. Lehna), [email protected] (P. Love), [email protected] (S. Holt), [email protected] (B. Stokley), [email protected] (A. Vissman), [email protected] (T. Kupiec), [email protected] (S. Starks), [email protected] (K. Chesser), [email protected] (H. Karem), [email protected] (A. Probus), [email protected] (K. Dunlap) 0882-5963/$ – see front matter © 2010 Elsevier Inc. All rights reserved. doi:10.1016/j.pedn.2009.11.003
fires and their associated injuries could be prevented with an increased awareness and knowledge concerning fires and burn prevention techniques. This includes responding promptly and quickly to fires by alerting the fire department, taking it upon oneself to learn ways in which fires can be prevented and implement them in one's own household, and sharing the information with others. The nurse is focused on the care of burn victims following an incident. It is important to change the nurse's focus to include primary prevention to help prevent the devastation that a fire injury causes a patient (Herndon, 2007; Lehna, 2007). Burn prevention education should be a part of the education process in the community, specifically in the pediatric population and their families (Lehna). Burn prevention knowledge assessment is an important consideration when evaluating children and their parents to ascertain the appropriate educational level and the teaching that is needed (Lehna). Within the community, there are thousands who have suffered the pain, anguish, and loss that surrounds a burn injury (Lehna). These consequences are as equally devastating to the family, and this need for education concerning prevention is necessary across the spectrum to impact change.
478
Purpose The purpose of this project was to look at different burn prevention strategies that could be utilized in the community to impact change in family burn prevention knowledge. One specific aim was for registered nursing students to support their burn prevention topic choice based on the existing burn prevention evidence. An additional aim was for nursing students to learn how to assess learning needs and develop and evaluate a burn prevention project with their patients. Furthermore, it was hoped that nursing students would understand the importance of collaborating with other agencies within their community to reach their goal. Ultimately, it was hoped that nursing students would provide the community with educational tools that could decrease the number of accidental fires and the injuries associated with them.
Project During the fall of 2008, 10 registered nursing students, in a baccalaureate nursing program during their pediatric clinical experience, developed burn prevention posters with accompanying one-page abstracts. A team of two students addressed one topic. The one-page abstract accompanying the posters described the target audience, why the topic was chosen, and how the poster was going to be used in prevention activities. Students, then, developed an evalua-
tion form that outside burn prevention experts could use to rate their abstracts and posters. The poster evaluation was based on the following areas: the creativity of the topic, creativity of the poster, content, clarity, and application. The areas for evaluation were further
C. Lehna et al. clarified as topic creativity met an identified community need; poster creativity conveyed the message through use of design, graphics, and text; content included identification of the target audience, provision of relevant information, and whether rationale for topic choice was supported with evidence; clarity evaluated poster readability; and application judged whether the poster was realistic and feasible. The students' clinical instructor asked a local platoon of firefighters from the Louisville Metro Fire Department to be evaluators. The areas of burn prevention chosen by the students based on their literature search were camp fire safety, candle safety, Christmas tree safety, electrical safety, and scald prevention.
Camp Fire Safety The topic of campfire safety was chosen to address the number of burns that are caused from camp fires and the amount of land that is destroyed due to improper camp fire activities (American Academy of Pediatricians, 2008; Life Learning Systems, 2008). In addition, this topic was chosen because many individuals are unaware of the proper techniques for conducting a safe bonfire and the negative impact that it can have if a safe environment is not maintained throughout the bonfire experience (Life Learning Systems). The NFPA reported in 2007 that 769,000 fires were from the outdoors resulting in 45 deaths, 650 injuries, and $790 million in loss (NFPA, 2008a). The NFPA also reported that 37% of outdoor fires were caused by an open flame such as a campfire.
Candle Safety The topic of candle safety was chosen due to its importance, the lead containing properties of candles, and the other parts of a candle that can impose harm to children
Evidence Based Research
479
(National Candle Association, 2008). According to the NFPA (2008b), “Candle fires resulted in an estimated 150 civilian deaths, 1,270 civilian injuries and an estimated direct property loss of $539 million.” Thus, the need for educating is importance when considering candle safety.
with household electrical cords and extension cords. Wall outlets are associated with an additional 14% of these injuries (NSKC).” It is anticipated that the education presented will teach children to avoid existing dangers and to notify a responsible adult to rectify the hazard.
Christmas Tree Safety
Therefore, by focusing on this age group and their caregivers, it is hoped that household electrical hazards will be identified and corrected before these problems result in fire and injury.
The topic of Christmas tree safety was chosen due to during the holiday season, many fires are the result of Christmas trees. According to the NFPA (2008), there is an average of 600 fires per year in the United States caused by the ignition of Christmas trees. On average, such fires result in 112 injuries and $21 million in direct property damage per year. Almost half of Christmas tree fires are caused by electrical failure or malfunction. By keeping your Christmas tree watered and properly maintained, the extent of a fire is drastically reduced. Several research videos are available to compare the spread of fire with a dry Christmas tree compared to a watered Christmas tree. Christmas tree fires can develop and spread very quickly (NFPA, 2008).
Electrical Safety The prevention strategy for electrical safety centered on a statistic from the National SAFE KIDS Campaign (NSKC, 2004), which stated that “nearly two thirds of electrical burn injuries among children ages 12 and under are associated
Scald Safety This topic of scald safety is important because it is the most common injury for young children. According to NFPA, fire and burns are the leading cause of unintentional injury-related death for children ages 1 to 4 years (Injury Prevention Web, 2008). In addition, according to the U.S. Consumer Product Safety Commission, approximately 3,800 injuries and 34 deaths occur in the home each year due to scalding from excessively hot tap water (Home Safety Council, 2008). Hot water, including tap water in bathtubs and showers, is the leading cause of both scalds and hospital admissions for burns (NFPA, 2008a). Because infants, young children, and older people may not be able to respond quickly to a situation involving contact with hot water, a constant safe water temperature is essential for preventing scalds from tap water (Injury Prevention Web, 2008).
480
C. Lehna et al.
Evidence Based Research The firefighters judged the Christmas tree safety poster best, followed by the camp fire safety poster, and in third place was the poster on electrical safety. Students, using these comments revised their posters and submitted them to a national fire prevention poster contest. Time did not allow for the students to implement their posters within the community and evaluate this phase of the project.
Discussion The inclusion of the burn prevention project provided an EBR component to the student's pediatric clinical experience. The EBR component supplied the students with experience in research techniques, working in groups to create their projects, analyzing data, investigating community resources, and writing findings. The clinical instructor and the students agreed that this project would be beneficial to the community by increasing awareness of the devastation that fires can bring and by providing interventions for preventing this devastation from occurring. The drawback was the timing of this project. According to the students and the supervising faculty, the students were overwhelmed by the requirements that had previously been set forth in their nursing classes and other clinical experiences. On the positive side, this project served to foster building a relationship between the students, the supervising faculty, and the local fire department. By speaking with each other, the students and firefighters strengthened their understanding of their respective roles in the prevention and treatment of fires and their resulting burns to children and their families. Plans are to continue using this type of project for future clinical groups. Project changes would be to describe requirements at the beginning of the clinical experience, to include implementation of projects in various settings, and to complete participant evaluation. The EBR helped the registered nursing students gain valuable mentored experience in researching, developing, evaluating, and disseminating the information from their
481 primary burn prevention projects. This experience was not without its negative perspectives and involved extra work on the part of all participants. Clear and detailed EBR requirement description, with requirements for implementation and evaluation, would facilitate future student learning of EBR principles. EBR evaluation data would provide valuable feedback in aiding student understanding of EBR within a specific setting and in developing and implementing burn prevention strategies to reduce devastating burn injuries in children. Implementation sites might include schools, children's toy and clothing stores, camp grounds, or building supply stores.
References American Academy of Pediatricians (AAP). (2008). Follow these hot tips for campfire safety. AAP News, 29, 29. American Burn Association (ABA). (2009). National burn repository. Chicago, IL: Author. Herndon, D. N. (2007). Total burn care. Philadelphia: W. B. Saunders. Home Safety Council. (2008). Home safety tips: Water safety tips. Available at: http://www.homesafetycouncil.org/safety_guide/sg_ water_w004.aspx/ Internet; accessed 28 Sept. 2008. Injury Prevention Web. (2008). Injury prevention policy: Tap water scalds. Available at: http://www.safetypolicy.org/pm/scald.htm Internet; accessed 28 Sept. 2008. Lehna, C. (2007). Pediatric nurses' knowledge about burn prevention. Journal of Burn Care & Research, 28, S114. Life Learning Systems. (2008). Campfire safety. Available at: http://www. smokeybear.com/campfire-safety.as Internet; accessed 30 Sept. 2008. National Candle Association. (2008). Available at: http://www.candles.org/ safety_candles.htm. Internet; accessed 29 Sept. 2008. National Fire Protection Agency (NFPA). (2008). Research and reports: Christmas tree fires. Available at: www.nfpa.org Internet; accessed 27 Sept. 2008. National Fire Protection Association (NFPA). (2008a). Fire statistics. Available at: http://www.nfpa.org Internet; accessed 24 Nov. 2008. National Fire Protection Association (NFPA). (2008b). Candle safety. Available at:. http://www.nfpa.org Internet; accessed 29 Sept. 2008. National SAFE KIDS Campaign (NSKC). (2004). Burn Injury Fact Sheet 2004. Available at: http://www.usa.safekids.org Internet; accessed 27 Sept. 2008. United States Fire Administration (USFA). (2008). Statistics. Available at: http://www.usfa.dhs.gov/statistics/quickstats/index.shtm Internet; accessed 24 Nov. 2008.