An effective burn prevention program initiated by a recovered burn patient group

The US death rate from house fires has remained constant during the past 50 years despite a sharp decline in mortality from other fires and causes of burns. The concensus is that smoke alarms can effectively decrease the incidence of this lethal type of burn injury. Our organization of recovered burn patients has focused its efforts around procuring and installing smoke alarms in areas of substandard housing, which predominantly account for house fire deaths and injuries in St. Louis. This effort has resulted in an effective burn prevention program ("Alarms for Life"), which also serves as a model for other communities.     

A statewide targeted burn prevention program

The statewide Burn Prevention Program has demonstrated a significant improvement in testable knowledge of burn prevention and fire safety among children and senior citizens as a result of an effective educational program. Formal evaluation using written examinations was done with the children. The statistical significance of the results of these evaluations was analyzed using chi square tests and two sample t tests. Significant improvements were seen in both mean test scores and the percentage of children answering all the test questions correctly. A much less formal type of evaluation was done with the elderly group. Senior citizens were assisted with a pre-program questionnaire. The results of this questionnaire were compared to the results of "BURN-GO" (copyright 1986), a bingotype game, played immediately after the educational session. Again, the post-implementation results of the program were significantly higher than those achieved prior to the intervention.     

A one-hour burn prevention program for grade school children: its approach and success

A brief, one-hour program aimed at grade school children combines human moderators, a robot, and cartoons to deliver the burn prevention message. Program efficacy was demonstrated by a pretest and posttest. Performance on the posttest improved with the age of the child.     

Evaluation of a peer consultation program for burn inpatients. 2000 ABA paper

A burn survivor may provide unique psychological support to patients who have been burned more recently and enhance their adjustment to burn injury. The purpose of this study was to describe the peer consultation/burn survivor support program at a large regional burn center in the Northwest United States. Over the course of 17 months, three specially trained peer consultants who had survived their own burn injuries in the past made 167 visits to 108 patients, who, in turn, completed evaluation forms for each visit. Findings indicated that patients reported that the peer consultants approached them in an appropriate manner, answered their questions, and provided useful support and information.     

An outreach burn prevention program for home care patients

Residential fires are the major cause of death from fires and burns in the United States, accounting for nearly two-thirds of annual fatalities. High-risk groups are more accessible now to burn prevention programs because of increasing home health care. Our burn prevention program, directed at homebound patients cared for by our hospital-based home care staff, combines fire safety education and smoke detector installation for this designated high-risk population. The combining of home health care with burn prevention activities has proven to be an effective means of reaching thousands of high-risk homes per year. We believe this approach would be equally effective in other areas.     

Evaluation of a self-directed smoking prevention and cessation program

This study evaluates a youth subject-directed smoking prevention and cessation program titled Breathe Easy! The program was delivered at two sites and a control group was recruited from two additional sites. Surveys were administered prior to the program and either 1 month or 6 months after completion at the exposure sites. The same survey administration procedure was used as the control. After controlling for invalid responses and including only those that completed both surveys, 251 exposure subjects and 159 control subjects remained for analysis. At sites with 1-month follow-up, no significant difference was noted between intervention and control groups. At the sites with 6-month follow-up, prevalence dropped from 18.7% to 8.9%, which is statistically significant, while at the control site prevalence changed from 14.1% to 9.4%, which is not significant. Additional outcomes examined in the exposed group showed trends toward smoking cessation and prevention at higher rates than those of the unexposed group.     

Evaluation of a peer-led falls prevention program for older adults

Waters DL, Hale LA, Robertson L, Hale BA, Herbison P. Evaluation of a peer-led falls prevention program for older adults.

Objective

To evaluate measures of strength and balance and falls incidence in participants attending fall prevention exercise classes taught by volunteer peer leaders, paid professional (Age Concern Otago group), or a comparison class (comparison group).

Design

Quasi-experimental evaluation with 12-month follow-up.

Setting

Community.

Participants

Older adults with increased fall risk (N=118; mean age, 75.5y; age range, 65–94y), with 23% drop out at 12 months.

Intervention

Peer-led group (n=52) and Age Concern Otago (n=41) weekly 1-hour strength and balance classes adapted from a home-based nurse/physical therapist–administered program and comparison group (n=25) 1-hour weekly seated exercise classes.

Main Outcome Measures

Timed Up and Go test, 30-second chair stand, functional reach, step touch, Single Leg Stand, and balance confidence at baseline, 10 weeks, and 6 and 12 months. Falls diaries collected monthly for 12 months. Continued exercise participation questionnaire at 6 and 12 months.

Results

At baseline, the peer-led group achieved normative standards on most tests and performed significantly better than the Age Concern Otago and comparison groups (overall P<.05). The Age Concern Otago group reached normative standards on most tests at 10 weeks. Functional improvements were similar in the peer-led group and Age Concern Otago groups from 10 weeks to 12 months, and all functional measures were significantly greater than in the comparison group (overall P<.02). Poisson regression showed a tendency for a 27% decrease in falls for the peer-led group compared with the comparison group (incidence rate ratio [IRR], .73; 95% confidence interval, .48–1.1; P=.07). Continued participation in strength and balance classes at 12 months was greater in the peer-led group and Age Concern Otago groups compared with the comparison group.

Conclusions

This peer-led model maintained measures of strength and balance and was superior to seated exercise. People in the Age Concern Otago group chose to continue these classes over other activities, whereas the comparison group had discontinued exercise classes by 12 months. Peer-led classes may decrease the fall incidence, although larger studies are needed to confirm this finding.     

Evaluation of a tobacco prevention program for children: ToPIC

This intervention study focused on evaluating the effectiveness of teaching tobacco prevention in children using ToPIC, an interactive program. The program was presented in 2 or 3 class sessions to increase awareness of health risks related to tobacco use. Participants consisted of 201 students from the Boys and Girls Clubs in 5 rural counties of a southeastern state. A significant increase in knowledge from pretest to posttest was found; t(200) = -13.65, p < .0001. Children's responses to the effects of smoking correlated to the content material incorporated in ToPIC. Recommendations for program improvement are discussed.     

Distance learning in a school nurse credential program.

Distance learning, which encompasses many methodologies, is becoming a more readily available educational alternative. Because there are a limited number of school nurse credential programs and the demand for school nurses is increasing, distance learning may be a viable method of instruction. This article describes the authors' experiences organizing and presenting distance learning courses to five remote sites for students in a university school nurse credential program. After numerous inquiries, potential students from several areas were surveyed, and arrangements were made with universities in those areas to receive two-way audio and video transmissions of two seminar courses; later, two clinically oriented courses in the school nurse program. Students were able to complete their program requirements by taking equivalent course work at their local universities. Perceptions of students and the instructor, course evaluation, and practical suggestions are shared. Guidelines for potential students about selecting quality distance education programs are also noted.     

Development of a skin cancer prevention program.

The Centers for Disease Control and Prevention (CDC) now categorizes skin cancer as epidemic. Nearly 90% of these deadly cancers start from sun exposure during the childhood years. This makes sun exposure in school-age children a serious public health risk, also one that school nurses can address. Solar radiation is now classified as a "known human carcinogen," with ultraviolet rays joining the ranks of other known cancer-causing elements such as tobacco, arsenic, and radon. Sun exposure to unprotected skin results in painful burns, premature aging, cataracts, and weakened immune systems. School nurses can use the new CDC guidelines along with other local and state resources to develop a specific skin cancer prevention program for their schools. They are in a pivotal position to partner with students, parents, administrators, teachers, and coaches to reduce the occurrence of skin cancer in children. The article describes one high school's skin cancer prevention project.     

Implementation of a patient fall prevention program.

Falls among hospitalized patients are common occurrences and can have detrimental effects on patient outcomes. Identifying high-risk patients and taking measures to prevent patient falls have been successful. The purpose of this project was to decrease the fall rate in adult neuroscience patients. This was accomplished through implementation of a patient fall prevention program. Patients were assessed for risk factors associated with patient falls. Risk factors were identified through the use of the patient's history, nursing data base and patient classification system. Patients with identified risk factors were placed on fall precautions which included interventions specifically designed to prevent patient falls. This project resulted in a decrease in the number of patient falls and increased staff awareness of the risk factors associated with falls among adult neuroscience patients.     

Implementing career development in a drug prevention program.

This article describes an innovative school and community based drug prevention program aimed at high risk urban youths. It is the result of the collaborative efforts of the nursing faculty of Lehman College-CUNY and the assistant district attorneys of the Office of the District Attorney of Bronx County. In the program, children learn first hand about career opportunities in nursing and law, and gain incentives to remain drug free.     

Evaluation of the cost-effectiveness of a multicomponent fall prevention program in hospitalized patients

The aim of this pre- and post-interventional study was to analyze the cost-effectiveness of the multicomponent fall prevention program in hospitalized patients. To achieve this aim, cost-effectiveness analysis performed using decision tree modeling was compared with the implementation of the fall prevention program and usual care. The primary outcome was the number of patient falls. The uncertainty in cost and effectiveness data was evaluated using one-way sensitivity analysis, best–worst-case scenario analysis, and probabilistic sensitivity analysis. According to cost-effectiveness analysis, implementation of the fall prevention program was dominantly cost-effective. As a result of the probabilistic sensitivity analysis, it was revealed that, even if willing-to-pay per-fall prevented value was 0, the probability of being cost-effective was 54.4% for the fall prevention program. Economic evaluation results showed that implementing the multicomponent fall prevention program was dominantly cost-effective in hospitalized patients. Nurses and nurse managers can benefit from economic evaluations in their decision-making processes to implement fall prevention programs.