Safe at Home: Prevention of Pediatric Unintentional Injuries

Coleman Burch, BS
Alicia Webb, MD
Eric Jorge, MD
Michele Nichols, MD
Kathy Monroe, MD

Unintentional injuries are the leading cause of death in children in the United States. Studies have shown that parental adherence to safety guidelines is improved over education alone when education is provided in conjunction with safety equipment. A prior study at this institution suggested the pediatric emergency department (PED) is an appropriate site for education and safety equipment distribution and showed that families were using devices at follow up. This study built on the prior study and primarily sought to determine if families had previously been educated by a healthcare professional about medication or firearm storage.

A survey about medication and firearm storage was administered to a convenience sample of caregivers presenting to a PED within a freestanding pediatric tertiary care center. The project partnered with the hospital foundation and the School of Medicine. English-speaking caregivers of patients with an Emergency Severity Index (ESI) score of 3, 4, and 5 were approached. Participants verbally completed a survey conducted by a medical student that was approximately five minutes in length. The student provided each family with a medication lock box (if children 5 years old or younger lived in the home), a firearm cable lock, and provided education for safe storage of medications and firearms in the home.

The medical student researcher spent a total of 20 hours in the PED from June to August 2021. 106 families were approached to participate in the study, of which 99 agreed to participate (93.4%). A total of 199 children were reached with ages ranging from less than 1 year old to 18 years old. A total of 73 medication lockboxes and 95 firearm locks were distributed. The majority (79.8%) of survey participants were the mother of the patient and 97.0% of participants lived with the patient more than 50% of the time. For medication storage, 12.1% of families stored medications locked and 71.7% reported never receiving medication storage education from a healthcare professional. Regarding firearms, 65.2% of participants who reported having at least one firearm in the home reported storing firearms safely (locked and unloaded). 77.8% of firearm owners reported storing ammunition in a separate location from the firearm. Of all participants surveyed, 82.8% reported never receiving firearm storage education from a healthcare professional.

The PED is an excellent setting for injury prevention education. Many families are not storing medications and firearms safely nor do they recall having ever received education from a healthcare professional. This demonstrates a clear opportunity to increase knowledge and safety behaviors for caregivers of children.

1) Understand whether caregivers remember having previously received anticipatory guidance on injury prevention methods from healthcare workers.
2) Discuss the importance of providing safety equipment alongside injury prevention education to increase adherence to safe behaviors.
3) Understand how the ED is an efficient and effective setting for injury prevention in pediatric populations.