Changes in U.S. fireworks laws have allowed younger children to purchase fireworks. In addition, the changes have allowed individuals to purchase more powerful fireworks. The purpose of this study is to examine the epidemiology of pediatric firework-related burn injuries among a nationally representative sample of the United States for the years 2006 to 2012. We examined inpatient admissions for pediatric firework-related burn patients from 2006 to 2012 using the nationwide inpatient sample and examined emergency department admissions using the nationwide emergency department sample. Both data sources are part of the Healthcare Cost and Utilization Project. Trajectories over time were evaluated. A total of 3193 injuries represented an estimated 90,257 firework-related injuries treated in the United States from 2006 to 2012. A majority of injuries were managed in the emergency department (n = 2008, 62.9%). The incidence generally increased over time; increasing from 4.28 per 100,000 population in 2006 to 5.12 per 100,000 population in 2012, P = .019. However, the proportion of injuries requiring inpatient admission (28.9% in 2006 to 50.0% in 2012, P < .001) and mean length of stay in the hospital (3.12 days in 2006 to 7.35 days in 2012, P < .001) significantly increased over time, while the mean age decreased over time (12.1-year-old in 2006 to 11.4-year-old in 2012, P = .006). The relaxing of U.S. fireworks laws may have had a modest effect on incidence of related injuries and the age of purchaser. However, it has had a dramatic effect on the severity of the related injuries, resulting in more inpatient admissions and longer length of stay in the hospital. Preventative methods should be taken to reduce the rate and severity of firework-related injuries among U.S. youths.
Advancing evidence-based practice in hospitals can be a challenge. To address this issue, a virtual journal club (VJC) was developed using available intranet technology. Research manuscripts are posted along with professional critiques and discussion questions. Comments from nurse VJC participants are reviewed by the hospital's nursing research council and analyzed for practice implications. Recommendations for practice change derived from the analysis are forwarded to the appropriate decision-making body for consideration. This process closes the loop ensuring that the VJC not only exposes the nursing staff to scientific evidence to support changing their practice but also may lead to institutional policy changes that are based on best practice evidence in the literature. The authors discuss the VJC and the outcomes of an evaluation project.
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